Awareness and Opinion of Nursing Mothers Towards Neonatal Sepsis in Oni and Sons Children’s Hospital
Chapter One
Objectives of the study
The main objective of the study is to examine the awareness and opinion of nursing mothers towards neonatal sepsis in Oni and Sons Children’s Hospital. The following are the specific objectives of the study:
- To examine the knowledge and awareness of nursing mothers at Oni and Sons Children’s Hospital.
- To explore the mother’s practice used during care of new born at Oni and Sons Children’s Hospital.
CHAPTER TWO
LITERATURE REVIEW
This chapter presents review of literature relevant to the study that was obtained from various sources that include; Medical and nursing journals, text books and internet and is presented in relation to the study objectives.
Conceptual review
Concept of Neonatal sepsis
Neonatal sepsis of the newborn is an infection that has spread through the entire body. The inflammatory response to this systematic infection can be as serious as the infection itself
(Pryhuber, 2015). In infants that weigh under 1500 g, sepsis is the most common cause of death. Three to four percent of infants per 1000 births contract sepsis. The mortality rate from sepsis is near 25% (Caserta, 2015). Infected sepsis in an infant can be identified by culturing the blood and spinal fluid and if suspected, intravenous antibiotics are usually started. Lumbar puncture is controversial because in some cases it has found not to be necessary while concurrently, without it estimates of missing up to one third of infants with meningitis is predicted (Bennett, 2015).
Neonatal infections are infections of the neonate (newborn) during the neonatal period or first four weeks after birth (Linda et al, 2015). Neonatal infections may be contracted by transplacental transfer in utero, in the birth canal during delivery (perinatal), or by other means after birth (David, 2014). Some neonatal infections are apparent soon after delivery, while others may develop postpartum within the first week or month. There is a higher risk of infection with preterm or low birth weight neonates. Respiratory tract infections contracted by preterm neonates may continue into childhood or possibly adulthood with long-term effects that limit one’s ability to engage in normal physical activities, decreasing one’s quality of life and increasing health care costs. In some instances, neonatal respiratory tract infections may increase one’s susceptibility to future respiratory infections and inflammatory responses related to lung disease (Polin, 2014).
Neonatal infection treatment is typically started before the diagnosis of the cause can be confirmed. Neonatal infection can be prophylactically treated with antibiotics. Maternal treatment with antibiotics is primarily used to protect against group B streptococcus (Pryhuber, 2015). Women with a history of HSV, can be treated with antiviral drugs to prevent symptomatic lesions and viral shedding that could infect the infant at birth. The antiviral medications used include acyclovir, penciclovir, valacyclovir, and famciclovir. Only very small amounts of the drug can be detected in the fetus. There are no increases in drug-related abnormalities in the infant that could be attributed to acyclovir. Long-term effects of antiviral medications have not been evaluated for their effects after growth and development of the child occurs. Neutropenia can be a complication of acyclovir treatment of neonatal HSV infection, but is usually transient. Treatment with immunoglobulin therapy has not been proven to be effective (Linda et al, 2015).
Antibiotics can be effective treatments for neonatal infections, especially when the pathogen is quickly identified. Instead of relying solely on culturing techniques, pathogen identification has improved substantially with advancing technology; however, neonate mortality has not kept pace and remains 20% to 50% (Mhairi, 2015).While preterm neonates are at a particularly high risk, full term and post-term infants can also develop infection. Neonatal infection may also be associated with premature rupture of membranes (breakage of the amniotic sac) which substantially increases the risk of neonatal sepsis by allowing passage for bacteria to enter the womb prior to the birth of the infant (Florin, 2021).
Knowledge and awareness of nursing mothers about neonatal sepsis
Lack of knowledge of about newborn care hampers prevention of neonatal sepsis for example lack of knowledge about standard cord care is an important factor underlying unhygienic umbilical cord management among mothers. Mothers who are knowledgeable of standard cord care and the possible risk for non-adherence are more likely to employ standard cord management (Goldman et al, 2019).
Available research studies revealed that mothers had average poor knowledge on new born care.
A descriptive study was conducted on “Knowledge, attitude and practice of neonatal care among nursing mothers in a tertiary care hospital, Neonatal Division, Department of Pediatrics, in South India among 100 nursing mothers on knowledge and attitude towards neonatal care and the practices they follow. Findings of the study showed that knowledge of mothers was inadequate in areas of umbilical cord care (35%), thermal care (76%) and vaccine preventable diseases. 19% of them still practice oil instillation into nostrils of newborns and 61% of them administer gripe water to their babies (Obimbo et al , 2019).
According to a study about Knowledge and practices of nursing mothers on newborn care in tertiary care hospital of Udupi district in India, it indicated that awareness and attitude of nursing mothers towards neonatal care has lots of gaps especially in those who belong to the lower socio-economic status. Thus the poor knowledge on part of Mothers could lead to disastrous results in the field of care giving. There is scope for improvement by providing better care and health education for antenatal mothers. If the mothers are not acquainted with knowledge pertaining to dangers signs, hygienic practices, feeding, weaning, health and nutrition including growth and behavior of children, it might affect the rearing of their children.
REFERENCES
- Agrawal PK, Agrawal S, Ahmed S, Darmstadt GL, Williams EK, Rosen HE, Kumar V, Kiran U, Ahuja RC, Srivastava (2022). Effect of knowledge of community health workers on essential newborn health care: A study from rural India. Health Policy Plan. 2022;14(2):115–126.
- Ann L Anderson-Berry, Linda L Bellig, and Bryan L Ohning (2015). “Neonatal Sepsis Clinical Presentation”. WebMD LLC.
- Ayiasi, R. M., Criel, B., Orach, C. G., Nabiwemba, E., & Kolsteren, P. (2014). Primary healthcare worker knowledge related to prenatal and immediate newborn care: A cross sectional study in Masindi, Nigeria. BMC Health Services Research, 14, 65.
- Bennett, John (2015). Mandell, Douglas, and Bennett’s principles and practice of infectious diseases. Philadelphia, PA: Elsevier/Saunders.
- Bua J, Mukanga D, Lwanga M and Nabiwemba E (2015). Risk factors and practices contributingto newborn sepsis in a rural district of Eastern Nigeria. BMC Res Notes (2015) 8:339
- Eriksson L, Malqvist M, Persson LA, Ewald U, and Wallin L (2019). Evidence-based practice in neonatal health. Knowledge among primary health care staff in northern Viet Nam. Hum Resour Health.
- Florin, Todd (2021). Netter’s pediatrics. Philadelphia, PA: Elsevier Saunders. ISBN 978–1–43771155–4.
- Ganatra H.A., and Zaidi A.K, (2020). Neonatal infections in the developing world. Semin Perinatol.Geneva.
- Goldman, S, Ellis, R, Dhar, V, and Cairo, M.S (2019). Rationale and potential use of cytokines in the prevention and treatment of neonatal sepsis. ClinPerinatol 25:699-710.
- Hyde, T.B., Hilger T.M., and Reingold A (2022).Trends in incidence and antimicrobial resistance of early-onset sepsis: population-based surveillance in San Francisco and Atlanta. Pediatrics 110:690–5.
