Browsing by Subject "Infant Care"
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Item Open Access Performance of accredited social health activists to provide home-based newborn care: a situational analysis.(Indian pediatrics, 2014-02) Das, Emily; Panwar, Dharmendra Singh; Fischer, Elizabeth A; Bora, Girdhari; Carlough, Martha CObjective
To assess Accredited social health activists' (ASHAs) ability to recognize illness in infants aged less than 2 months.Methods
Investigators observed 25 ASHAs conducting 47 visits.Results
ASHA-investigator agreement on the need to further assess infants was intermediate (kappa 0.48, P<0.001). Using IMNCI's color codes, ASHAs misclassified 80% of infants. ASHAs did not follow home-based newborn care formats and skipped critical signs. Overall ASHA-investigator agreement on diagnosis was poor (kappa=0.23, P=0.01).Conclusion
There is a need for improved training, tools, and supportive supervision.Item Open Access Quality improvement initiative to improve infant safe sleep practices in the newborn nursery.(BMJ open quality, 2022-08) Shaikh, Sophie Kay; Chamberlain, Lauren; Nazareth-Pidgeon, Kristina Marie; Boggan, Joel CThe American Academy of Pediatrics recommends that healthcare professionals model their safe infant sleeping environment recommendations, yet adherence to safe sleep practices within our community hospital mother-baby unit was low. We used quality improvement (QI) methodology to increase adherence to infant safe sleep practices, with a goal to improve the proportion of infants sleeping in an environment that would be considered 'perfect sleep' to 70% within a 1-year period. The project occurred while the hospital was preparing for Baby Friendly certification, with increased emphasis on rooming in and skin to skin at the same time.Multiple Plan-Do-Study-Act cycles were performed. Initial cycles targeted nurse and parental education, while later cycles focused on providing sleep sacks/wearable blankets for the infants.While we did not meet our goal, the percentage of infants with 'perfect sleep' increased from a baseline of 41.9% to 67.3%, and we also saw improvement in each of the individual components that contribute to this composite measure. Improvements were sustained over 12 months later, suggesting that QI interventions targeting infant safe sleep in this inpatient setting can have long-lasting results. This project also suggests that infant safe sleep QI initiatives and preparation towards Baby Friendly Hospital Certification can be complementary.Item Open Access The effect of systematic pediatric care on neonatal mortality and hospitalizations of infants born with oral clefts.(BMC pediatrics, 2011-12-28) Wehby, George L; Castilla, Eduardo E; Goco, Norman; Rittler, Monica; Cosentino, Viviana; Javois, Lorette; Kindem, Mark; Chakraborty, Hrishikesh; Dutra, Graca; López-Camelo, Jorge S; Orioli, Iêda M; Murray, Jeffrey CCleft lip and/or palate (CL/P) increase mortality and morbidity risks for affected infants especially in less developed countries. This study aimed at assessing the effects of systematic pediatric care on neonatal mortality and hospitalizations of infants with cleft lip and/or palate (CL/P) in South America.The intervention group included live-born infants with isolated or associated CL/P in 47 hospitals between 2003 and 2005. The control group included live-born infants with CL/P between 2001 and 2002 in the same hospitals. The intervention group received systematic pediatric care between the 7th and 28th day of life. The primary outcomes were mortality between the 7th and 28th day of life and hospitalization days in this period among survivors adjusted for relevant baseline covariates.There were no significant mortality differences between the intervention and control groups. However, surviving infants with associated CL/P in the intervention group had fewer hospitalization days by about six days compared to the associated control group.Early systematic pediatric care may significantly reduce neonatal hospitalizations of infants with CL/P and additional birth defects in South America. Given the large healthcare and financial burden of CL/P on affected families and the relatively low cost of systematic pediatric care, improving access to such care may be a cost-effective public policy intervention.ClinicalTrials.gov: NCT00097149.