Browsing by Author "Singh, R"
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Publication Quality of care provided to newborns by nursing personnel at BP Koirala Institute of Health Sciences(Kathmandu University, 2009) Shrestha, M; Singh, R; Upreti, DAbstract Background: Birth is a major challenge for the newborn to negotiate successfully from intrauterine to extra uterine life. The first few hours since birth is the most crucial period in the life of an infant for further growth and development, which is largely determined by the quality of care that the newborn receives. Objective: The aim of this study is to assess the quality of care provided by nursing personnel to newborn in the labour room. Materials and methods: This study was conducted in BP Koirala Institute of Health Science. Cross sectional, non participatory observational research design was adopted for the study. Care provided by nursing personnel to 814 normal newborns was observed. Samples were chosen by non probability purposive sampling technique. Data was collected through observational method by trained nursing personnel, using 46 items pre-tested, validated and self developed observational checklist. Care provided to newborns was observed from birth to two hours and categorised as good, average and poor based on scores obtained. Data was entered and analysed using SPSS-10. Descriptive statistics- [Mean, percentage, frequencies and standard deviation] was used to describe the quality of care provided to the newborn babies. Results: Overall quality of care was good in 42.36%, average in 57.64% and none of them received poor care. Overall mean score for quality of care was 34.75/46 (75.54 %). Regarding subscales quality of care was good in majority of newborns in areas such as Preparation to receive the baby (76.1%), Initiation of breathing (100%), Maintaining thermoregulation (77.3%), Physical assessment (90.9%), and other aspects of care (95.2%). However the quality of care was poor in majority of newborns in establishment of breast feeding (58.23%) and average in prevention of infection (76.9%). Conclusion: Study findings highlight the need for focus in establishment of breast feeding and prevention of infection. Key words: Quality of care, newborns, nursing personnel, breast feeding, prevention of infection and assessment of newborn.Publication Risk of neonatal hyperbilirubinemia in babies born to ‘O’ positive mothers: A prospective cohort study(Kathmandu University, 2009) Kalakheti, BK; Singh, R; Bhatta, NK; Karki, A; Baral, NAbstract Introduction: Hyperbilirubinemia in a neonate is one of the most common problems that may occur in 60-70 % of term and 80% of preterm babies. It is known to be associated with significant morbidity like neonatal bilirubin encephalopathy and even death. Clinically, and almost exclusively ABO incompatibility occur in ‘A’ and ‘B’ blood group babies of O ‘+ve’ mothers. These babies are reported to be at high risk of severe hyperbilirubinemia (serum bilirubin level more than 16 mg/dl). Objectives: To find out the incidence of hyperbilirubinemia in babies born to ‘O’ positive mothers. To estimate the risk of ABO incompatibility in babies born to ‘O’ positive mothers. Materials and methods: A prospective cohort study conducted in B. P. Koirala institute of Health Science (Department of Pediatrics and Dept. of Gynae and Obstetric) from July 2002 to June 2003. A total of 199 women having ‘O’ positive blood group admitted to the Department of Gynae and Obstetric were included in the study. A piloted proforma was used to collect information. The blood group of neonates was tested by tile and slide method and serum bilirubin was estimated by diazo method in the Central Laboratory Services and Emergency laboratory of BPKIHS. The data was observed and analysis was carried out using statistical software SPSS-10. Results: Total 37 (18.5%) babies had developed hyperbilirubinemia and among them 14 (38%) were from group of babies having ‘O’ Positive blood group and 23 (62%) were from group of babies having other than ‘O’ Positive blood group. There was 2.6 times higher chance of having hyperbilirubinemia in the babies with ABO incompatibility than ‘O’ Positive babies after adjusting other significant variables. Conclusion: Among different significantly associated variables, ABO incompatibility was found to be a major risk factor for neonatal hyperbilirubinemia.It was seen that neonate with ABO incompatibility had two times higher chances of having hyperbilirubinemia than those babies with O ‘+ve’ blood group. This finding in BPKIHS suggests that there is a need of screening cord blood bilirubin and continuous monitoring of bilirubin level in the hospital especially among ABO incompatible neonates. Key words: Hyperbilirubinemia, Neonatal Jaundice, ABO-incompatibility