Basic newborn resuscitation guidelines for healthcare providers in maragua district hospital: A best practice implementation project

Objective: The overall aim of this project was to assess compliance with evidence-based criteria regarding newborn resuscitation among healthcare workers in the maternity units in Maragua District Hospital (a busy district hospital in Kenya). Introduction: Globally, the majority of deaths under five years are attributable to neonatal causes. Perinatal asphyxia accounts for a significant portion of these deaths, especially in developing countries. These deaths are largely preventable, and interventions geared towards assisting newborns to initiate their first breath within the first minute of life have markedly reduced mortality. Methods: This implementation project was conducted in the maternity units of a busy district hospital. Evidencebased audit criteria were developed on the basis of an evidence summary developed by the Joanna Briggs Institute (JBI). Using the JBI Practical Application of Clinical Evidence System software (JBI PACES), a baseline audit was conducted including a sample size of 55 healthcare providers and 300 patient case notes followed by an identification of potential barriers and strategies to overcome them. A follow-up audit including a sample size of 55 healthcare providers was conducted by using the same audit criteria. Results: Improvements in practice were demonstrated in all criteria. The baseline audit demonstrated that three of the five audit criteriawere found to be less than 50%, indicatingmoderate compliancewith current evidencewith regards to newborn resuscitation. Following implementation of the strategies, which included a six-week education and demonstrative skills training, and updating of the protocols and equipment, there was a significant improvement in all the criteria audited, with the first four criteria achieving 100% compliance, and the fifth criteria achieving 90% compliance. Conclusion: On completion of the project, the participants demonstrated an increase in knowledge and skills on newborn resuscitation, which led to a significant reduction in admission of newborns with birth asphyxia to the newborn unit

Basic newborn resuscitation guidelines for healthcare providers in maragua district hospital: A best practice implementation project

Objective: The overall aim of this project was to assess compliance with evidence-based criteria regarding newborn resuscitation among healthcare workers in the maternity units in Maragua District Hospital (a busy district hospital in Kenya). Introduction: Globally, the majority of deaths under five years are attributable to neonatal causes. Perinatal asphyxia accounts for a significant portion of these deaths, especially in developing countries. These deaths are largely preventable, and interventions geared towards assisting newborns to initiate their first breath within the first minute of life have markedly reduced mortality. Methods: This implementation project was conducted in the maternity units of a busy district hospital. Evidencebased audit criteria were developed on the basis of an evidence summary developed by the Joanna Briggs Institute (JBI). Using the JBI Practical Application of Clinical Evidence System software (JBI PACES), a baseline audit was conducted including a sample size of 55 healthcare providers and 300 patient case notes followed by an identification of potential barriers and strategies to overcome them. A follow-up audit including a sample size of 55 healthcare providers was conducted by using the same audit criteria. Results: Improvements in practice were demonstrated in all criteria. The baseline audit demonstrated that three of the five audit criteriawere found to be less than 50%, indicatingmoderate compliancewith current evidencewith regards to newborn resuscitation. Following implementation of the strategies, which included a six-week education and demonstrative skills training, and updating of the protocols and equipment, there was a significant improvement in all the criteria audited, with the first four criteria achieving 100% compliance, and the fifth criteria achieving 90% compliance. Conclusion: On completion of the project, the participants demonstrated an increase in knowledge and skills on newborn resuscitation, which led to a significant reduction in admission of newborns with birth asphyxia to the newborn unit

Clinical laboratory reference values amongst children aged 4 weeks to 17 months in Kilifi, Kenya: A cross sectional observational study

Reference intervals for clinical laboratory parameters are important for assessing eligibility, toxicity grading and management of adverse events in clinical trials. Nonetheless, haematological and biochemical parameters used for clinical trials in sub-Saharan Africa are typically derived from industrialized countries, or from WHO references that are not region-specific. We set out to establish community reference values for haematological and biochemical parameters amongst children aged 4 weeks to 17 months in Kilifi, Kenya. We conducted a cross sectional study nested within phase II and III trials of RTS, S malaria vaccine candidate. We analysed 10 haematological and 2 biochemical parameters from 1,070 and 423 community children without illness prior to experimental vaccine administration. Statistical analysis followed Clinical and Laboratory Standards Institute EP28-A3c guidelines. 95% reference ranges and their respective 90% confidence intervals were determined using non-parametric methods. Findings were compared with published ranges from Tanzania, Europe and The United States. We determined the reference ranges within the following age partitions: 4 weeks to <6 months, 6 months to less than <12 months, and 12 months to 17 months for the haematological parameters; and 4 weeks to 17 months for the biochemical parameters. There were no gender differences for all haematological and biochemical parameters in all age groups. Hb, MCV and platelets 95% reference ranges in infants largely overlapped with those from United States or Europe, except for the lower limit for Hb, Hct and platelets (lower); and upper limit for platelets (higher) and haematocrit(lower). Community norms for common haematological and biochemical parameters differ from developed countries. This reaffirms the need in clinical trials for locally derived reference values to detect deviation from what is usual in typical children in low and middle income countries

Bergbau und verarbeitendes Gewerbe in Nordrhein-Westfalen: Produktion ausgewaehlter Erzeugnisse 1978-1984 Regionalergebnisse nach Guetergruppen 1983 und 1984

Bibliothek Weltwirtschaft Kiel C 136051 / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekSIGLEDEGerman

95% reference ranges with 90% confidence intervals for selected biochemistry parameters for Kilifi children aged 1–17 months.

<p>95% reference ranges with 90% confidence intervals for selected biochemistry parameters for Kilifi children aged 1–17 months.</p

95% reference ranges with 90% confidence intervals for selected white blood cells parameters for Kilifi children aged 1–17 months.

<p>95% reference ranges with 90% confidence intervals for selected white blood cells parameters for Kilifi children aged 1–17 months.</p

95% reference ranges with 90% confidence intervals for selected haematological parameters for Kilifi children aged 1–17 months.

<p>95% reference ranges with 90% confidence intervals for selected haematological parameters for Kilifi children aged 1–17 months.</p

Participant flow diagram.

<p>Participant flow diagram.</p

95% reference intervals for white blood cell counts for Kenyan infants aged 1 to less than 12 months, compared to published data from Tanzania and United States/Europe.

<p>95% reference intervals for white blood cell counts for Kenyan infants aged 1 to less than 12 months, compared to published data from Tanzania and United States/Europe.</p

95% reference intervals for selected haematological parameters: Kenyan infants aged 1 to less than 12 months (current study), compared to published data from Tanzania and United States/Europe.

<p>95% reference intervals for selected haematological parameters: Kenyan infants aged 1 to less than 12 months (current study), compared to published data from Tanzania and United States/Europe.</p