Assistant Professor, Department of Neonatology, St. John's Medical College, Bengaluru, Karnataka, India.
Associate Professor, Department of Neonatology, St. John's Medical College, Bengaluru, Karnataka, India.
Indian J Public Health. 2019 Oct-Dec;63(4):357-361. doi: 10.4103/ijph.IJPH_419_18.
It has been possible to set up special newborn care units (SNCUs) and to improve the survival of newborns in India. However, several challenges remain affecting their effective functioning. Different approaches have been attempted and several policies have also been implemented to address this issue.
To evaluate the feasibility of implementing best practices in neonatal care by onsite mentoring in an SNCU over 4 months.
The mentoring team was from a tertiary care hospital in Karnataka. The SNCU was functioning at the district hospital, catering to approximately 3500 live births per year. Onsite mentoring was carried out from August 2016 to November 2016. This was a prospective implementation research. Framework focused on infection control, preterm care, care at birth, advocacy for infrastructure and resources, and facility-based refresher training.
A total of 16 visits were done by the mentoring team and 2 weeks of in-house residency. There were improvements in hand hygiene compliance from 0% to 87.5%, in cleaner IV site (from 50% to 100%), decreased unnecessary oxygen administration (from 75% to 33.3%), decreased antibiotic usage (from 70.5% to 35.5%), decrease in the number of babies receiving >5 days of antibiotics (from 41.6% to 0%), and increased kangaroo mother care initiation rate from 0% to 41.6%. The facility got level IIA accreditation by the end of the intervention period.
Onsite mentorship program of SNCU is feasible and planning should be contextual. With the problems being uniform across most facilities, the model could be replicated across the country.
在印度，已经可以建立专门的新生儿护理单元（SNCU）并提高新生儿的存活率。然而，仍有一些影响其有效运作的挑战存在。为了解决这个问题，已经尝试了不同的方法，并实施了几项政策。
评估通过在 SNCU 进行现场指导，在 4 个月内实施新生儿护理最佳实践的可行性。
指导团队来自卡纳塔克邦的一家三级护理医院。SNCU 在地区医院运作，每年大约有 3500 例活产。现场指导于 2016 年 8 月至 2016 年 11 月进行。这是一项前瞻性实施研究。框架侧重于感染控制、早产儿护理、出生时护理、基础设施和资源倡导以及基于设施的复习培训。
指导团队共进行了 16 次访问和 2 周的内部居住。手卫生依从性从 0%提高到 87.5%，清洁的 IV 部位从 50%提高到 100%，不必要的氧气使用减少（从 75%降至 33.3%），抗生素使用减少（从 70.5%降至 35.5%），接受 >5 天抗生素治疗的婴儿数量减少（从 41.6%降至 0%），袋鼠妈妈护理开始率从 0%提高到 41.6%。该设施在干预期结束时获得了 IIA 级认证。
SNCU 的现场指导计划是可行的，规划应因地制宜。由于大多数设施都存在同样的问题，因此该模式可以在全国范围内复制。
