Assessment of Newborn Resuscitation Practice by Nurses in Machakos Level 5 Hospital, Machakos County, Kenya
Muli, Musyoki Daniel
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The first minute after birth is usually referred to as the golden minute, and the baby should be able to initiate spontaneous breathing, failure to which birth asphyxia ensues. Globally, approximately 5% to 10 per cent of newborns require resuscitation. In sub-Saharan Africa where over one third of all intrapartum related neonatal deaths occur, the rates of skilled attendance at birth are very low. In Kenya neonatal mortality remains at 22/100,000 live births, majority associated with poor resuscitation. This study sought to assess neonatal resuscitation practice among nurses in Machakos Level 5 Hospital, in Machakos County, Kenya. The study aimed at identifying individual, knowledge and health system factors that influences practice of neonatal resuscitation among nurses. The study adopted a descriptive cross-sectional study design. The study population included nurses working in Machakos level 5 hospital in Machakos County. The study sampled 201 nurses involved in neonatal resuscitation who were interviewed. Quantitative data was collected using semi-structured questionnaires from selected nurses through systematic random sampling at a predetermined interval of 2. Every second respondent was selected for interview until the required sample was reached for interviewing. Qualitative data was collected using key informant interview schedules with 6 selected Key Informants. Key informants were purposively selected for inclusion in the study. The researcher sought all required approvals from relevant authorities and ensured study participants gave an informed consent prior to the conduct of the study. Descriptive statistics were calculated using Statistical Package for Social Sciences version 22 with the aid of Microsoft Excel program to generate frequency tables, graphs and pie-charts. Qualitative data was analyzed using thematic analysis and results triangulated with quantitative data as direct quotes or narrations. To test the association between study variables, Chi-Square tests done was at 95% confidence interval (p<0.05) were used. The study results revealed that 41 per cent of respondents fully practiced neonatal resuscitation. Individual factors such as age (p=0.001), years in current position (p=0.001), highest level of education (p=0.021), training on neonatal resuscitation and performance of neonatal resuscitation (0.001) were associated with practice of neonatal resuscitation. Health system factors such as availability of resuscitation equipment (p=0.001), place of keeping resuscitation equipment (p=0.021) and reference to guidelines (p=0.001) had a significant influence on neonatal resuscitation practice. The study results further revealed that 56 per cent of respondents had high knowledge on neonatal resuscitation. Knowledge level (p=0.001) significantly affected practice of neonatal resuscitation. The study conclude that a significant large number of respondents did not fully achieve neonatal resuscitation despite majority of them being knowledgeable on neonatal resuscitation. The study recommends on job training and seminars on newborn resuscitation towards improving the practice of neonatal resuscitation. The hospital administration should sponsor nurses to specialize in neonatal care and ensure that each department has a team leader to offer mentorship to others in order to reduce neonatal mortality.