Causes of Infant Mortality in Babol, Northern Iran

Background and Objective: Infant mortality is an important health indicator. In order to reduce infant mortality, its causes should be considered in each region so that steps can be taken to improve the quality of health care and treatment. Therefore, this study was conducted in order to determine the causes of infant mortality in Babol, northern Iran. Methods: This cross-sectional study was conducted on all infants who died in public and private hospitals of Babol. The cause of infant death was extracted and analyzed based on the International Classification of Diseases 10th Revision (ICD-10) and also based on laboratory, clinical and paraclinical evidence recorded in the files. Findings: Out of a total of 16,005 live births in Babol, 123 infants (7.6%) died, of which 53 (43.1%) died in the first 24 hours of life. The mean gestational age of the deceased cases was 31.4±5.5 weeks, the mean birth weight was 1705.4±1045.3 grams, and their mean life span was 5.4±6.6 days. The most common causes of infant mortality were prematurity (30%), congenital anomalies (25.3%), sepsis (17.1%) and respiratory distress syndrome (13%). Conclusion: The results of the study showed that the most common causes of infant mortality are prematurity and congenital anomalies

An Audit of Nursing Care and Placement of Peripherally Inserted Central Catheter in Infants

Background and Objective: The performance quality of peripherally inserted central catheter (PICC) by nurses has a direct effect on the improvement of patient care and safety. The aim of this study is to audit the placement and nursing care of PICC in infants. Methods: This cross-sectional study was conducted on 130 PICC procedures in the neonatal intensive care units of Rouhani and Amirkola hospitals in Babol in 2018-2021. All infants who needed PICC placement for any reason were selected. In order to collect the data, the observational researcher-made checklist and the infant demographic characteristics questionnaire were used. The checklist included 44 questions and four parts of nursing care before catheter insertion, hand washing, nursing care during the procedure, and nursing care after catheter placement. The scores obtained from the checklist were classified into conversion percentage and two groups of unfavorable placement (less than 67) and favorable placement (68-100). To confirm its reliability, intraclass correlation coefficient was used (ICC=0.90). Findings: A total of 130 cases of PICC placement and nursing care were audited (Rouhani Hospital 98 cases 75.4%, Amirkola 32 cases 24.6%). In the studied sample, 83 (63.8%) were boys and 53 (43.1%) were diagnosed with prematurity. The most common PICC location was the armpit (42.3%). The percentages of compliance of nursing care before PICC insertion according to the standard (97.43%), hand washing (100%), nursing care during the procedure (87.14%) and nursing care after PICC insertion (94.84%) were favorable. Nurses did not use glasses and ultrasound guidance during PICC insertion; (85.4%) and (90%), respectively. Conclusion: According to the results of this study, although the quality of PICC insertion and care in three stages was at a favorable level, nurses need training regarding the use of glasses and ultrasound guidance during PICC insertion

Challenges and Practical Solutions for Pain Management Nursing in ‎Pediatric Wards ‎

BACKGROUND AND OBJECTIVE: Pain management is one of the most important indicators for nursing care quality. Pain management is still ineffective and inadequate in pediatric wards. Therefore, in this study, we aimed to evaluate pain management nursing in pediatric wards and suggest practical solutions with regard to pediatric pain control. METHODS: In this review article, Iranian (i.e., MagIran, Iran Medex, Irandoc, and SID) and international (i.e., Medline, Google Scholar, Google, and Science Direct) databases were searched, using the following keywords and their Farsi equivalents: “pain management”, “pediatric”, “nurse”, “barriers”, and “hospital”. Among 4064 studies, 51 relevant articles, published during 1994-2015, were retrieved and reviewed in this study. FINDINGS: In total, eight challenging areas were recognized in pediatric pain management, which are as follows: limited theoretical knowledge and insufficient skills of nursing staff, nurses’ personal beliefs, organizational barriers, characteristics of parents and children, lack of professional interaction, ambiguous role of nurses in pain management, lack of parental involvement or children’s participation in pain management, and scarcity of local models for pain management.   CONCLUSION: By identifying nursing challenges and proposing practical solutions (e.g., modifications in organizational structure), we hope to take a major step towards removing barriers against pediatric pain management

Comparison of the Effect of Massage with Coconut Oil and Sunflower Oil on the Growth of Premature Infants

BACKGROUND AND OBJECTIVE: Prematurity and low birth weight are one of the major health problems and the most common causes of infant mortality. Infant massage is potentially beneficial for physiological and psychological health. The present study was conducted to compare the effect of massage with coconut oil and sunflower oil on the growth of premature infants. METHODS: This clinical trial was performed on 100 premature infants admitted to the neonatal intensive care unit of Amirkola Children's Hospital in 2018 in four groups of 25 infants. Infants of the intervention groups with one cc of sunflower oil and coconut oil and the oil-free massage group were massaged for 15 minutes three times a day for seven days with the help of a research assistant, and the control group received only routine care. The weight, height, and head circumference of infants were collected using a personal profile questionnaire and compared in four groups at the beginning and end of the intervention. FINDINGS: Comparison of mean weight and head circumference changes at the end of the first week between coconut oil massage group (0.134±0.334 cm, 6.81±3.04 g), sunflower oil massage group (0.239±1.172 cm, 6.35±2.69 g), oil-free massage group (1.061±1.534 cm, 2.95±2.65), and control group (0.663±1.174 cm, 3.52±4.38 g) showed significant difference (p<0.05). Comparison of mean height changes in different groups (0.413±0.739, 0.448±0.747, 0.458±0.693, 0.429±0.611 cm, respectively) did not show any significant difference. CONCLUSION: The results of the study showed that oil massage is recommended as it increases the rate of changes in weight gain and head circumference in premature infants

An Audit of Nursing Care and Placement of Peripherally Inserted Central Catheter in Infants

Background and Objective: The performance quality of peripherally inserted central catheter (PICC) by nurses has a direct effect on the improvement of patient care and safety. The aim of this study is to audit the placement and nursing care of PICC in infants. Methods: This cross-sectional study was conducted on 130 PICC procedures in the neonatal intensive care units of Rouhani and Amirkola hospitals in Babol in 2018-2021. All infants who needed PICC placement for any reason were selected. In order to collect the data, the observational researcher-made checklist and the infant demographic characteristics questionnaire were used. The checklist included 44 questions and four parts of nursing care before catheter insertion, hand washing, nursing care during the procedure, and nursing care after catheter placement. The scores obtained from the checklist were classified into conversion percentage and two groups of unfavorable placement (less than 67) and favorable placement (68-100). To confirm its reliability, intraclass correlation coefficient was used (ICC=0.90). Findings: A total of 130 cases of PICC placement and nursing care were audited (Rouhani Hospital 98 cases 75.4%, Amirkola 32 cases 24.6%). In the studied sample, 83 (63.8%) were boys and 53 (43.1%) were diagnosed with prematurity. The most common PICC location was the armpit (42.3%). The percentages of compliance of nursing care before PICC insertion according to the standard (97.43%), hand washing (100%), nursing care during the procedure (87.14%) and nursing care after PICC insertion (94.84%) were favorable. Nurses did not use glasses and ultrasound guidance during PICC insertion; (85.4%) and (90%), respectively. Conclusion: According to the results of this study, although the quality of PICC insertion and care in three stages was at a favorable level, nurses need training regarding the use of glasses and ultrasound guidance during PICC insertion