Journal Issue: Volume: 43, No. 1 (2023)
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Volume
Number
Issue Date
2023
Journal Title
Journal ISSN
ISSN 1990-7974 eISSN 1990-7982
Journal Volume
Articles
Parental Satisfaction with the Care of Admitted Children in a Tertiary Level Hospital
(Nepal Paediatric Society (JNPS), 2023) Pandey, Kabita; Shrestha, Sanjana; Shrestha, Sarala
Abstract:
Introduction: The quality care is an essential aspect of hospital service in improving health outcomes. Quality of children’s care can be assessed by measuring the parental satisfaction.
Methods: A descriptive cross-sectional design was used. Non-probability purposive sampling was used to select 167 parents of children who were admitted in Kanti Children Hospital. Data were collected by interviewing either the father or mother as roomed-in by using the Pediatric family satisfaction questionnaire (PFSQ) containing three domains as modified to suit to local context. Data were entered, cleaned and analyzed in statistical package for the social sciences SPSS version 22. Chi-square test and Spearman rank correlation coefficient were used to analyze the data.
Results: Findings revealed that the overall satisfaction among majority (59.9%) of the respondents was low. However, domain wise, almost all (94.6%) respondents were satisfied in medical care followed by 89.2% in nursing care and lowest proportion (42.5%) was satisfied with hospital services and accommodation. Parental overall satisfaction was significantly higher among those admitted in surgical unit (p = 0.00) and among those with days of hospitalization as more than 6 days (p = 0.01). Findings also showed a moderate correlation between the satisfaction with nursing care and medical care (r = 0.64).
Conclusions: Parents tend to have low satisfaction with the care provided to the admitted children whereas domain wise satisfaction is high in medical and nursing care and low in hospital services. Therefore, in order to increases the parental satisfaction, more focus should be given to improve the quality of hospital services and accommodation.
Assessment of Bacterial Profile and Antimicrobial Susceptibility Pattern of Bacterial Isolates from Blood Culture in Tertiary Level Paediatric Hospital of Nepal
(Nepal Paediatric Society (JNPS), 2023) Shrestha, Anil Kumar; Sharma, Nisha; Bhattrai, Pratiksha; Pokhrel, Nayanum; Bajracharya, Sohani; Sah, Umesh Prasad; Paudel, Prajwal
Abstract:
Introduction: Bloodstream infection is a major cause of morbidity and mortality which requires antibiotic treatment. Antimicrobial resistance is an emerging serious public health threat in both developed and developing countries. Children are more susceptible to infections requiring an appropriate choice of antibiotic based on blood culture. This study aims to investigate the bacteriological profile and antibiotic sensitivity pattern of blood culture isolates and compare the yield of bacterial growth between Brain Heart Infusion Broth (BHIB) or BD BACTEC culture media.
Methods: A total of 12,795 blood samples were sent for bacteriological culture either for BHIB or BACTEC techniques, 10994 and 1801 samples respectively. Chi-square test was used for showing association between BACTEC and BHIB among isolates.
Results: The findings showed that the BACTEC method detected more positive isolates than the BHIB method. The rate of isolation was found highest among children under five years. The most common pathogens isolated were Staphylococcus species (28.1%), Staphylococcus aureus (25.6%), Acinetobacter species (12%), Pseudomonas species (8.2%), Klebsiella species (6.6%), CONS (4.4%), Escherichia coli (4.4%), Salmonella Typhi (3.5%), Enterobacter species (3.2%) and Streptococcus species (0.3%).
Conclusions: Staphylococcus aureus was the commonest isolate identified in the current study. BACTEC culture method detected the higher percentage of isolates than BHIB method.
Behavioural Profile, Linguistic skills, Adaptive Behaviours and Intellectual Functioning of School aged Children with History of Early Language Delay
(Nepal Paediatric Society (JNPS), 2023) Gupta, Arpita; Nair, MKC; George, Babu; ML, Leena
Abstract:
Introduction: Language is a fundamental skill and a foundation stone for multiple cognitive and socio-emotional aspects of development. Considering that well-developed language abilities enable children to negotiate the social-relational demands of school life and provide the foundational knowledge upon which academic skills are built, there is a higher chance of scholastic difficulties, social and, behavioural and emotional maladjustments resulting in poor mental health in those who have language delay.
Methods: An ambispective study conducted at a tertiary centre after taking ethical approval from the institutional review board. Children with isolated early language delay were reassessed at school age for intelligence quotient, language development, adaptive behaviours and behavioural issues.
Results: out of 57 children, persistence of poor language skills was seen in 65%, mean IQ score was 90 ( ± 17. 067) and mean VABS score was 94 ( ± 15). 61.4% children had significant behavioural issues. On interview, most worrisome issue reported by children was ‘being teased by friends’ due to poor language skills. Additionally, lower social competence level was noted in children who had poor language skills.
Conclusions: persistence of language, cognitive and behavioural dysfunctions in children with seemingly benign ‘speech and language delay’ at an early age, emphasizes the importance of comprehensive reassessment of these children at school age for early recognition and management.
Diagnostic Accuracy of Haematological Scoring System in Paired cord Blood and Peripheral Venous Blood for early Detection of Neonatal Sepsis – A Prospective Analytical Study
(Nepal Paediatric Society (JNPS), 2023) Shukla, Gagandeep; Goyal, Prachi; Arya, Sunil
Abstract:
Introduction: Sepsis is one of the major causes of neonatal morbidity and mortality. Early recognition and diagnosis of early onset neonatal sepsis (EONS) is difficult. Hence, there is a need for early predictive screening method for EONS, for which Haematological Scoring System (HSS) is used. It comprises of total leucocyte count, immature / total neutrophil ratio, total PMN count, immature PMN count, degenerative changes in PMN and platelet count.
Methods: 100 inborn neonates with two or more risk factors for EONS, chosen by sequential sampling method were included in this prospective analytical study. Blood samples were collected from umbilical cord and peripheral vein and analysed for haematological parameters. Blood cultures were performed as gold standard for diagnosing neonatal sepsis and sepsis screen was done to corroborate the diagnosis of EONS.
Results: Out of 100 neonates, 21 had sepsis, 14 had probable sepsis and 65 had no sepsis. Among the variables of HSS it was observed that elevated I:T ratio, thrombocytopenia, elevated I:M ratio and elevated immature neutrophil count have shown significant correlation with EONS with statistically significant p values (p value < 0.05), with raised I:T ratio being highly sensitive in identifying neonatal sepsis and degenerative changes in neutrophils being highly specific.
Conclusions: The HSS was found to be satisfactory in identifying EONS. It can be used as a simple, quick, cost effective and readily available screening test with decent sensitivity and high specificity, for detection of EONS.
Effectiveness of Video-Assisted Distraction Technique in Reduction of Pain Among Preschool Children Undergoing Vein Puncture
(Nepal Paediatric Society (JNPS), 2023) Mishra, Tulashi Adhikari; Subedi, Aastha
Abstract:
Introduction: Vein puncture is an invasive but common procedure for children, often accompanied by pain, fear and anxiety and refuse to cooperate. Distraction technique is one of the non-pharmacological methods of controlling pain. The objective of this study was to find the effectiveness of video assisted distraction technique in reduction of pain among preschooler children.
Methods: Quasi experimental study was conducted in Bharatpur Hospital, Chitwan, Nepal. 108 preschooler children consisting of 54 children in each experimental and control group selected by non-probability purposive sampling technique were enrolled in the study. Structured pain scale was used to collect data in both groups. Animated cartoon video was shown only to experimental group five minutes prior to until the vein puncture was over. Data analysis was done using descriptive statistics and inferential statistical tests.
Results: In experimental group, 59.2% had moderate pain whereas 68.5% in control group had severe pain. The pain score of experimental group was significantly lower than that of control group at p = 0.05 with the mean value of experimental and control group 6.85 ± 0.79 and 7.25 ± 0.87 respectively.
Conclusions: Distraction is an effective technique for children undergoing vein puncture in order to alleviate pain level during vein puncture