ASSESSMENT OF KNOWLEDGE AND PRACTICES ON NEONATAL RESUSCITATION AMONG MIDWIVES AT KAMPALA INTERNATIONAL UNIVERSITY TEACHING HOSPITAL

TABLE OF CONTENTS

ABSTRACT.................................................................................................................................... i

COPYRIGHT................................................................................................................................ ii

Copyright © (2016) by Kembabazi Recheal............................................................................... ii

DECLARATION..........................................................................................................................iii

APPROVAL FOR SUBMISSION.............................................................................................. iv

SUPERVISORS’ APPROVAL................................................................................................... iv

DEDICATION............................................................................................................................... v

ACKNOWLEDGMENT ............................................................................................................. vi

LIST OF FIGURES ...................................................................................................................... x

LIST OF TABLES ........................................................................................................................ x

ACRONYMS................................................................................................................................ xi

OPERATIONAL DEFINITIONS ............................................................................................. xii

CHAPTER ONE ........................................................................................................................... 1

1.1 Introduction......................................................................................................................... 1

1.2 Background information.................................................................................................... 1

1.3 Statement of the Problem................................................................................................... 3

1.4 Purpose of the study............................................................................................................ 4

1.4.1 Study Objectives........................................................................................................... 4

1.4.2 General objective ......................................................................................................... 4

1.4.3 Specific objectives ........................................................................................................ 5

1.5 Research questions.............................................................................................................. 5

1.6 Justification for the study.................................................................................................. 5

CHAPTER TWO: LITERATURE REVIEW............................................................................ 7

2.1 Introduction......................................................................................................................... 7

2.2 Knowledge of neonatal resuscitation................................................................................. 7

2.3 Practices during neonatal resuscitation.......................................................................... 10

2.3.1 Practices immediately after birth of the baby. ........................................................... 12

2.3.2 Practices after five minutes of birth. ........................................................................... 13

2.4. Availability of equipments .............................................................................................. 14

CHAPTER THREE: METHODOLOGY ................................................................................ 15

3.1 Introduction....................................................................................................................... 15

3.2 Study design and rationale............................................................................................... 15

3.3 Study setting and rationale .............................................................................................. 15

3.4: Study Population ............................................................................................................. 16

3.4.1: Sample Size Determination ........................................................................................ 16

3.4.2: Sampling procedure..................................................................................................... 18

3.4.3: Inclusion Criteria ......................................................................................................... 18

3.4.4: Exclusion criteria. ........................................................................................................ 18

3.5 Definitions of variables..................................................................................................... 19

3.6 Research instruments ....................................................................................................... 19

3.7 Data collection procedure................................................................................................. 19

3.7.1 Data management.......................................................................................................... 20

3.7.2 Data analysis.................................................................................................................. 20

3.8 Ethical consideration ........................................................................................................ 20

3.9 Study Limitations.............................................................................................................. 21

3.10: Dissemination of findings.............................................................................................. 22

CHAPTER FOUR: PRESENTATION OF STUDY FINDINGS ........................................... 23

4.1 Introduction....................................................................................................................... 23

4.2 General information ......................................................................................................... 23

4.4 ASSESSMENT ON PRACTICES ON NEONATAL RESUSCITATION .................. 30

CHAPTER FIVE: DISCUSSION OF FINDINGS, CONCLUSIONS AND

RECOMMENDATIONS............................................................................................................ 35

5.1 Introduction....................................................................................................................... 35

5.2 DISCUSSION OF FINDINGS......................................................................................... 35

5.3 CONCLUSSIONS............................................................................................................. 38

5.4 RECOMMENDATIONS.................................................................................................. 39

5.5 Implications to Nursing Practice. .................................................................................... 40

REFERENCES............................................................................................................................ 41

APPENDICES............................................................................................................................. 45

APPENDIX I: INFORMED CONSENT FORM ................................................................. 45

APPENDIX II: QUESTIONNAIRE FOR MIDWIVES .................................................... 46

APPENDIX III: LETTER OF APPROVAL........................................................................ 55

APPENDIX IV: RESEARCH WORKPLAN....................................................................... 56

APPENDIX V: RESEARCH BUDGET ............................................................................... 57

APPENDIX VI: MAP OF UGANDA.................................................................................... 58

APPENDIX VII: MAP OF BUSHENYI-ISHAKA MUNICIPALITY .............................. 59

ABSTRACT

A cross sectional descriptive study was carried among midwives at Kampala International University Hospital to assess their knowledge and practices on neonatal resuscitation. A sample size of 30 midwives was used. Midwives were selected by using systematic sampling technique including all midwives who work in the maternity ward and neonatal intensive care unit. More than half 16(53.3%) of the midwives were between 20 – 30 years, only 1(3.3%) was above 50 years of age. All 30(100%) of the respondents were females. A half 15(50%) of the midwives were enrolled with a certificate in midwifery, 9(30%) were registered midwives, while 3(10%) were certificate holders in comprehensive nursing and another 3(10%) were Bachelor holders in nursing sciences. Majority of the midwives 25(83.3%) had last trained in neonatal resuscitation at the nursing school, 3(10%) had last trained in a workshop while only 2(6.7%) had last trained in a CME/CNE. Almost all midwives were knowledgeable on the resuscitation steps of a new born. The respondents had some knowledge on how to place a face mask on the neonate’s face. The majority of the midwives 18(60%) evaluated respirations, heart rate and colour of the neonate while 12(40%) were not observed to monitor heart rate. Three quarters 21(70%) of the midwives were observed correctly providing positive pressure ventilation with a resuscitation bag with supplemental oxygen, and a third 9(30%) did not administer epinephrine with continued ventilation and chest compression. The maternity and neonatal intensive care units were equipped with almost all the required resuscitation equipment except the cardiac monitor, carbon dioxide detector (capnograph) and naloxone hydrochloride injection. The researcher concluded that majority of the midwives had substantial good knowledge on neonatal resuscitation and despite the good knowledge, a significant proportion of them 12(40%) lacked skilled practices on resuscitation.