KNOWLEDGE AND PRACTICE ON PREVENTION OF NEONATAL HYPOTHERMIA AMONG THE NURSES IN SELECTED HOSPITALS, KAMRUP METRO ASSAM WITH A VIEW TO DEVELOP AN INFORMATION BOOKLET: A DESCRIPTIVE STUDY

Hypothermia is one of the main risk factor of neonatal morbidity and mortality in developing countries like India. Most of the studies found that newborn babies of developing countries have a highest risk of LBW and preterm due to low socio economic condition so the neonates have a highest chance to get hypothermia. . Neonatal hypothermia is caused more due to lack of knowledge among the nurses than lack of the equipment like radiant warmer, blower, and incubator. The newborn baby has immature thermoregulatory controls during the early neonatal period. So, nursing personnel need to focus here. The aim Aim: of the study was to assess the Knowledge and practice on prevention of neonatal hypothermia among the nurses. A descriptive researc Methods and Materials: h design used to accomplish the objectives. Study was undertaken on 60 nurses working in NICU and postnatal ward in selected hospitals, Kamrup (M) Assam by using convenience sampling technique.Participents were selected on the basis of inclusion and exclusion criteria. Structure knowledge questionnaires, observation checklist were used to assess knowledge and practice. A descri Conceptual framework: ptive research design was used in this study and convenience sampling technique for obtaining adequate sample technique for obtaining adequate sampling technique for obtaining adequate sample for the study. Study was undertaken on 60 nurses in selected hospitals of Kamrup (M), Assam with the inclusive criteria. Knowledge questionnaire and observation checklist was used to assess knowledge and practice on prevention of neonatal hypothermia among the nurses. In this study, modied Nola J Pender's health promotion model was used for conceptual framework. In knowledge, majority 57% of Results: respondents had moderate knowledge, 38% of the respondents had inadequate knowledge and 5% of the respondent had adequate knowledge on prevention of neonatal hypothermia. In practice, majority 62% of respondents had fair practice, 38% had good practice and 0% had poor practice on prevention of neonatal hypothermia. The mean score of knowledge was 15.20±3.74 and the mean score of practice was 9.20±1.31. The calculated Karl Pearson's Correlation Value of r = 0.259 shows a positive correlation between knowledge and practice scores which clearly infers that when the knowledge on prevention of neonatal hypothermia among the Nurses increases their practice level also increases. There was signicant association of knowledge and practice with demographic variable like educational qualication and working area. However there was no signicant association the knowledge score and practice score with their selected demographic like age in year,gender,work experience and training attended. Thus the study concluded that majority of the nurses had moderat Conclusion: e knowledge and practice on prevention of neonatal hypothermia. The nurses need continuous in –service and training education with continuous observation of practice on prevention of neonatal hypothermia which will help to increase their knowledge as well as their practices

Temperature Monitoring Devices in Neonates

Introduction: Accurate temperature monitoring of neonates is vital due to the significant morbidities and mortality associated with neonatal hypothermia. Many studies have compared different thermometers in neonates, however, there is a lack of consensus regarding which of the currently available thermometers is most suitable for use in neonates.Objectives: The aim of this review was to identify and compare current methods available for temperature monitoring of neonates beyond the delivery room, including the accuracy, advantages and disadvantages of each.Methods: A recent search and narrative synthesis of relevant studies published between January 1, 1949 and May 5, 2021 on the OVID Medline, PubMed and Google Scholar databases.Results: A total of 160 papers were retrieved for narrative synthesis. The main methods available for temperature monitoring in neonates are human touch and mercury-in-glass, electronic, infrared tympanic and other infrared thermometers. Newer innovations that are also available include liquid crystal thermometers and the BEMPU TempWatch. This paper discusses the current evidence available regarding the utility of these devices, and identifies barriers to valid comparison of different thermometry methods.Conclusion: Many methods for temperature monitoring in neonates are currently available, each with their own advantages and disadvantages. However, the accuracies of different devices are hard to determine due to variable methodologies used in relevant studies and hence, further research that addresses these gaps is needed.

EFFECTIVENESS OF POLYETHYLENE SKIN WRAP IN PREVENTION OF HYPOTHERMIA IN PRETERM AND LOW BIRTH WEIGHT NEONATES

Objective: To establish the effectiveness of polyethylene skin wrap in prevention of neonatal hypothermia in preterm and low birth weight neonates. Study Design: Quasi-experimental study. Place and Duration of Study: Department of Pediatrics, Combined Military Hospital Quetta, from May 2015 to Apr 2017. Methodology: A total of 176 neonates were enrolled according to the inclusion and exclusion criteria, through non-probability consecutive sampling. Eighty eight newborns were randomly distributed to each of group “A” and “B” by lottery method. The intervention group “A” infants were wrapped in a polyethylene skin wrap from shoulders down while the control group “B” newborns were wrapped with conventional blankets. After shifting to neonatal intensive care unit, axillary temperatures were recorded with similar pediatric digital thermometers upon admission and after one hour and two hours following admission in the two groups. Results: The mean temperatures measured at one hour and two hours after admission showed significant statistical improvements in the intervention group as compared to the control group (<0.05). Conclusion: The use of polyethylene skin wrap in preterm and low birth weight neonates potentially offers a useful intervenetion in prevention of neonatal hypothermia.

Neonatal hypothermia and adherence to World Health Organisation thermal care guidelines among newborns at Moi Teaching and Referral Hospital, Kenya

Neonatal hypothermia is a great concern with near epidemic levels globally. In Kenya, its prevalence is as high as 87% with limited local data on the associated factors such as adherence to warm chain guidelines as recommended by the World Health Organisation (WHO) is limited. This study aimed to determine the prevalence of hypothermia and level of adherence to the WHO thermal care guidelines among newborns admitted at Moi Teaching and Referral Hospital (MTRH). It adopted a prospective study design of following up neonates for the first 24 hours of admission to the MTRH newborn unit. Thermometry, interview of mothers and observation of thermal care practices was done. Descriptive and inferential statistical techniques were adopted. Specifically, Pearson’s chi-square test of associations between predictors of neonatal hypothermia and management outcomes was conducted with their corresponding risk estimates at 95% confidence interval. Among the 372 participants, 64.5% (n = 240) were born at MTRH, 47.6% (177) were preterm and 53.2% (198) had birth weights below 2500 grams. Admission hypothermia was noted among 73.7% (274) and 13% (49) died on the first day of admission. Only 7.8% (29) newborns accessed optimal thermal care. Prematurity, day one mortality and adherence to the warm chain were significantly (p<0.001) associated with admission hypothermia. Inappropriate thermal appliance, inadequate clothing and late breastfeeding significantly increased the risk of neonatal hypothermia. Absence of admission hypothermia increased the likelihood of neonatal survival more than twenty-fold (AOR = 20.91, 95% CI: 2.15–153.62). Three out four neonates enrolled had admission hypothermia which was significantly associated with prematurity, lack of adherence to warm chain and increased risk of neonatal mortality on the first day of life. There was low adherence to the WHO thermal care guidelines. This should be optimized among preterm neonates to improve likelihood of survival.

Neonatal hypothermia in Northern Uganda: a community-based cross-sectional study

ObjectiveTo determine the prevalence, predictors and case fatality risk of hypothermia among neonates in Lira district, Northern Uganda.SettingThree subcounties of Lira district in Northern Uganda.DesignThis was a community-based cross-sectional study nested in a cluster randomised controlled trial.ParticipantsMother–baby pairs enrolled in a cluster randomised controlled trial. An axillary temperature was taken during a home visit using a lithium battery-operated digital thermometer.Primary and secondary outcomesThe primary outcome measure was the prevalence of hypothermia. Hypothermia was defined as mild if the axillary temperature was 36.0°C to <36.5°C, moderate if the temperature was 32.0°C to <36.0°C and severe hypothermia if the temperature was <32.0°C. The secondary outcome measure was the case fatality risk of neonatal hypothermia. Predictors of moderate to severe hypothermia were determined using a generalised estimating equation model for the Poisson family.ResultsWe recruited 1330 neonates. The prevalence of hypothermia (<36.5°C) was 678/1330 (51.0%, 95% CI 46.9 to 55.1). Overall, 32% (429/1330), 95% CI 29.5 to 35.2 had mild hypothermia, whereas 18.7% (249/1330), 95% CI 15.8 to 22.0 had moderate hypothermia. None had severe hypothermia. At multivariable analysis, predictors of neonatal hypothermia included: home birth (adjusted prevalence ratio, aPR, 1.9, 95% CI 1.4 to 2.6); low birth weight (aPR 1.7, 95% CI 1.3 to 2.3) and delayed breastfeeding initiation (aPR 1.2, 95% CI 1.0 to 1.5). The case fatality risk ratio of hypothermic compared with normothermic neonates was 2.0 (95% CI 0.60 to 6.9).ConclusionThe prevalence of neonatal hypothermia was very high, demonstrating that communities in tropical climates should not ignore neonatal hypothermia. Interventions designed to address neonatal hypothermia should consider ways of reaching neonates born at home and those with low birth weight. The promotion of early breastfeeding initiation and skin-to-skin care could reduce the risk of neonatal hypothermia.Trial registration numberClinicalTrial.gov as NCT02605369.

The Prevalence and Associated Factors of Neonatal Hypothermia within Six Hours of Birth among Newborns in Pokhara

Background: Hypothermia is an important cause of neonatal morbidity and mortality. Persistent hypothermia leads to cold injury that results edema, scleroderma, pulmonary hemorrhage, jaundice and death. The objective of this study was to identify the prevalence and associated factors of neonatal hypothermia among newborns within six hours of Birth in Pokhara. Methods: The institutional based quantitative descriptive cross sectional study was done among 402 systematic randomly selected respondents by using structured format and digital thermometer MT 100 after taking ethical approval from Nepal Health Research Council and Pokhara Academy of Health Sciences. Data was analyzed by using SPSS version 20. Multivariate logistic regression analysis was done for the variables (p<0.25) in bivariate analysis. The variables (p< 0.05) with Adjusted Odds ratio (AOR) at 95% CI in the multivariate logistic regression was considered as independent associated variables. Results: The prevalence of neonatal hypothermia in the study area was about 43 percent. The significant independent factors of neonatal hypothermia were maternal age after 35 years (p=0.03, AOR: 4.087, 95% CI: 1.12-14.97), inadequate antenatal care (p=0.03, AOR: 0.52, 95% CI: 0.29-0.94), low birth weight (p=0.00, AOR: 0.433, 95% CI: 0.24- 0.77) and resuscitated babies at birth (p =0.00, AOR: 3.808)95% CI: 1.69- 4.65). Conclusion: Out of 10 births, four babies were hypothermic in study site. Mother’s age more than 35 years, inadequate antenatal care, low birth weight and resuscitation at birth were associated factors of Neonatal hypothermia. So, special care is necessary for low birth weight babies and during resuscitation.