Background: A majority of the 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.
Objectives: 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.
Methods: This implementation project was conducted in the maternity units of a busy district hospital in Kenya. Evidence-based audit criteria (Table 1) were developed on the basis of an evidence summary developed by the Joanna Briggs Institute. Using the Joanna Briggs Institute Practical Application of Clinical Evidence System software, a baseline audit was conducted including a sample size of 55 health care providers and 300 patient case notes followed by an identification of potential barriers and strategies to overcome them (Table 2). A follow-up audit including a sample size of 55 healthcare providers was conducted by using the same audit criteria.
Results: The baseline audit (Figure 1) demonstrated that three of the five audit criteria were found to be less than 50% indicating moderate compliance with current evidence with regards to newborn resuscitation. Following implementation of the strategies (Table 1), which included a six-week education and demonstrative skills training, updating of the protocols and equipment, there was a significant improvement in all the criteria audited. Subsequently the first four criteria achieving 100% compliance, and the fifth criteria achieving 90% (Figure 2).
Conclusions: On completion of the project there was an increased awareness on newborn resuscitation. There was also a significant reduction in admission of newborns with birth asphyxia to the newborn unit.