Knowledge And Skill Among Nurses Health And Social Care Essay

Review of literature is a systematic search of a published work to gain information about a research topic (Polit and Hungler).

This chapter deals with the related literature review which aids to generate a picture of what is known and not known about a particular situation.

The literature review was based on extensive survey of books, journals and international nursing studies. A review of literature relevant to the study was undertaken which helped the investigator to develop insight into the problem and gain information on what has been done in the past. An extensive review of literature was done by the investigator to lay a broad foundation for the study and a conceptual framework framed based on Hildegard peplu’s interpersonal theory to proceed with the study under the following headings.

The logical sequence of the chapter is organized in the following section:

2.1 Part – I Reviews related to effectiveness of essential newborn care module on knowledge and skill among nurses.

2.2 Part – II : Reviews related to knowledge and skill of newborn resuscitation among nurses.

2.1 Part – 1: Reviews related to effectiveness of essential newborn care module on

knowledge and skill among nurses.

Joshi, P. (2012) conducted a randomized controlled trail, to evaluate the knowledge and skills of essential newborn care among student nurses. After the training on essential newborn care the student nurses knowledge and skills score were gained than before training. The study concluded thus using essential newborn care as new technology in class room teaching may be an effective method.

Garclrs, A., et al. (2012) conducted population based, prospective, interventional pre – post design study on essential newborn care course among traditional birth attendants. This study analyzed the effect of training and implementation of the essential newborn care. The study concluded that the essential newborn care training reduced still births. Scale-up of this intervention in other settings help to assess reproducibility.

Elliott-Carter N., Harper J (2012) stated that, keeping mother and newborn together during the time immediately after delivery has several benefits, which is the components of essential newborn care. A new care delivery model was instituted so the women who delivered by cesarean were able to recover with their infants and the outcome has been very positive with increased satisfaction as well as the promotion of breast feeding and maternal – infant bonding.

Sodani PR, Sharma K (2011) conducted a case study on essential newborn care at Baratpur. Data were collected through structured questionnaire and evaluated. The result showed that in the communities the infrastructure of newborn care unit should have adequate facility and community health centre birth attenders should have knowledge and practice in newborn care.

Pradhan Y V., et al. (2011) stated an over view of implementation of essential newborn care program. Effective implementation of community based intervention program are an essential step to avert newborn death, in settings where the health facilities are unable to effectively deliver the intervention.

Saravanan S., et al (2011) conducted a study to assess the effectiveness of essential newborn care program during delivery and in community care in developing countries. The aim of the study to assess the post training program and in disseminating evidence based knowledge on essential newborn care program. The finding suggested that the training program improve the knowledge and practice among birth attendants.

Goudar, SS., et al. (2011) conducted a community based cluster randomized controlled trial to evaluate the effect of WHO essential newborn care course on perinatal mortality among birth attendants, Karnataka, India. Using a pre – post design WHO essential newborn care community birth attendant training resulted in a significant reduction in perinatal mortality. In low resource settings, the newborn care training package appears to be an effective intervention to decrease perinatal mortality.

Matendo R., et al (2011) conducted a secondary analysis on the effect of training of essential newborn care program among traditional birth attendants and midwives in Democratic Republic of Congo. The study revealed that training midwives and birth attendants reduces perinatal mortality after the training. There was a gradual but significant decline in neonatal mortality during the year following essential newborn care training which was independently associated with following training.

Manasyan A., et al (2011) conducted the study to evaluate the WHO essential newborn care training in Zambia. Data were extracted the effectiveness of essential newborn care was evaluated. Training of essential newborn care was given to clinical midwives in their first level facilities. Before and after study of the effect of essential newborn care was evaluated. The result showed that, after the training neonatal mortality decreased from 11.5 per 1000 to 6.8 per 1000 live births.

Samson LF (2011) stated that, the training on essential newborn care among midwives in low cost intervention reduces the neonatal mortality. Newborn infants need some form of assistance after birth. Only 1% will require more advanced form of care. Because the rare events cannot be always anticipated, pediatricians and neonatologist may not be readily available and the care should be performed but the nurses. Provision of essential newborn care training may improve the knowledge among midwives.

Grady K., et al., (2011) conducted an observational study to assess the effectiveness of essential newborn care are key strategies for reducing newborn mortality and morbidity globally. Lack of adequately trained competent staff is a key barrier to achieving this. Assessed the effectiveness of a new package of ‘Life Saving Skills – Essential Newborn Care Training designed specifically around the UN signal functions in seven countries in sub-Saharan Africa. Among 600 healthcare providers (nurse-midwives, doctors, clinical officers and specialists), knowledge about the child birth as well as newborn care significantly increased. There was measurable improvement in skills, and participants expressed a high level of satisfaction with the training. The training package was found to meet the needs of healthcare providers, increased awareness of the need for evidence-based care and encouraged teamwork.

Adhisivam B., et al., (2010) in Indian pediatric articles stated that the effectiveness of essential newborn care a need to reorient nursing staff. Improvement of knowledge and skills reduces the mortality and morbidity of newborn and maternal morbidity level. Newborn needs some kinds of assistance in the external environment. The reorientation of essential newborn care increases the newborn care among nurses.

Kirkwood BR., et al., (2009) conducted a Newhints cluster randomized trial to evaluate the impact on package on essential newborn care intervention. The study aims in Ghana, to develop a feasible and sustainable community-based approach to improve newborn care practices and improved neonatal survival. The result stated that the package intervention should significant improvement in knowledge and skills among birth attendants.

Darmstadt GL., et al (2009) conducted the study cluster-randomized controlled trial among birth attendants in Mirzapur, Bangladesh. The level and cause-structure of neonatal mortality in the local population must be considered in developing interventions.The study emphasis the programs must ensure skilled care during childbirth. The findings shows the programe reduced the primary causes of the death. Primary outcome measures were immediate newborn care behaviors, knowledge of danger signs, care seeking for neonatal complications, and neonatal mortality.

Carlo, WA.,et al.(2010) conducted a pre experimental study to evaluate the effectiveness of essential newborn care program in improving knowledge, skills and self-efficacy among nurses working in low risk delivery clinics in USA. After training, written scores improved from 57% to 80%, performance scores improved from 74% to 90%. The study revealed that essential newborn care training program has the potential to substantially improve the knowledge and skills of essential newborn care.

Opiyo, N.,& English, M. (2010) conducted a study to investigate the effectiveness in-service training on essential newborn care among health workers in Kenya. Independently selected the study and abstracted data using a standardized form to assess the study quality. The study results shows there were significant improvement in performance reduction in the potentially harmful practice and improvement in the delivery room following implementation of essential newborn care training.

Ariff, S. Soofi, S.B. (2010) conducted a need assessment analysis on knowledge and practice of neonatal care among health care providers in the public sector of Pakistan. The nurses knowledge was good with 30% scoring more than 70% and 50% were able to demonstrate steps of immediate newborn care. The study revealed that training of health worker is very vital to address the gaps and to develop continuing education modules.

Monebenimp, F., et al. (2009) conducted an observational study to evaluate the competence of health care providers towards newborn care at birth in Cameroon. The results showed that there is a need to reinforce the ability of health care providers by training in WHO essential newborn care with emphasis on providing skills on essential newborn care in order to reduce the burden neonatal related deaths.

Kesterton, AJ., & Cleland J. (2009) conducted a prospective survey among birth attendants in Karnataka. An interview schedule was done individually and found that many potentially harmful newborn practices are being carried out in that area. A package of essential newborn care practices exists, which has a proven impact on reducing newborn mortality. Successful implementation of essential newborn care package increased the knowledge.

Vittner, D. (2009) in his articles on essential newborn care states that, the newborn intensive care unit is technology focused and crisis driven. Working in that area demands technical competence as well as the emotional aptitude to ensure that infant should care in the environment of basic humanness. Essential newborn skills that enhances the nursing profession. In an effort to make change in newborn intensive care unit have to incorporate reflective process to prepare the nurses to improve their knowledge in implementing essential newborn care.

Vidal SA., et al. (2009) conducted a study to compare the effectiveness of two training strategies for improving essential newborn care in the state of Pernambuco, Brazil. . Doctors and nurses working at hospitals in Group 1 were given a conventional 5-day training course. Those in Group 2 were given the same manual used by Group 1 but the training course was organized as self-directed learning, with the participants having 5 weeks to complete the course. Participants’ knowledge was tested at baseline, immediately after the course. Participants’ practices were observed before training and knowledge were tested by interview method. The result showed that improved knowledge and skills.

Agrawal PK., et al.(2009) conducted study and explored the knowledge of essential newborn health care practices among community health workers, Anganwadi workers and auxiliary nurse midwives in rural India. Using principle component analysis, knowledge scores for preventive care and danger signs were computed separately. A multivariate logistic regression model was used to estimate the adjusted effect of knowledge level. A generalized estimating equation (GEE) was used to account for clustering there were significantly higher improvement in knowledge and skills compared with those with control group. Knowledge is one of the crucial aspects of health systems to improve the coverage of community-based newborn health care programe as well as adherence to essential newborn care practices at the care level.

Chomba E., et al. (2008) conducted controlled study to test the effect of WHO essential newborn care training on neonatal mortality by education among nurses in first level urban community health centers Zambia. Protocols and essential newborn care certified course were given. The data were collected after one week. The study showed that essential newborn care training is associated with decreased in early neonatal mortality, rates from 11.2% to 6.2% after the training.

Osrin D., et al. (2008) conducted the study to implementing a community based participatory intervention to improve the effectiveness of essential newborn care with women and other key members in community in rural Nepal. Each group moved through a participatory assessment, sharing experiences, planning, action and reassessment, with the aim of improving essential newborn care. Outcomes assessed are neonatal mortality rates, health care seeking and referral. The result showed that implementing essential newborn care programe reduced mortality among newborn.

Senarath U., et al. (2007) conducted the study to evaluate the effectiveness of a training program for care providers in improving practice of essential newborn care in obstetric units in Puttalam, Sri Lanka. The design used was before-and-after study with an intervention and a control group. A 4-day training program given on essential newborn care for doctors, nurses, and midwives of the obstetric units in two hospitals. The data collected by direct observation, practices of essential newborn care at delivery in the labor room. The evaluation was done by direct observation, practices of essential newborn care at delivery in the labor room. The result showed that the comprehensive 4-day training program showed significant improvement in essential newborn care practices in obstetric units.

Uxa, F., et al.(2006) in his articles stated that training of health care professionals and health policy makers in the field of essential newborn care is one of the corner stone’s of the WHO initiatives making pregnancy safer and promoting effective perinatal care. After the training the positive changes in planning for and delivering neonatal care taking place, even in challenging contexts.

Elizabeth, M., Mcclure., et al. (2005) conducted a pre-experimental study to evaluate the educational impact of newborn care among 115 nurses in Global network for women and children health research, Zambia. The post test score for knowledge was increased to 89% from 68% and practices were increased to 81% from 65%. The study concluded that there is improvement of knowledge and practice after essential newborn care training.

2.2 Part – II: Reviews related to knowledge and skill of newborn resuscitation

among nurses

Matendo.,et al.(2011) conducted a secondary analysis on the effect of training of newborn resuscitation program among traditional birth attendants and midwives in Democratic Republic of Congo. The study showed that training midwives and birth attendants reduces newborn mortality. There was a significant decline in newborn mortality during the following newborn resuscitation program training.

Kalmbach, K. (2011) stated that, successful resuscitation of newborn infants depends on adequate preparation, exact evaluation and prompt initiation of support by trained personnel’s, especially by the health care professionals. Adequate ventilation is the most important step in newborn resuscitation.

Nelson, C.A., et al. (2011) conducted a pre-experimental study to quantify newborn resuscitation capacity at birthing sites in urban and rural Nepal among health care workers. Assessment included standardized interviews and evaluation of newborn resuscitation areas. The tool was recorded. The study result revealed that , there was a improvement in skill and knowledge, when caregivers have proper training of essential newborn care.

Anne., et al. (2011) conducted a systemic review and Delphi estimation of mortality effect of neonatal resuscitaion among 136 million babies born annualy, the study revealed that around 10 million require assistance to breathe and each year 814,000 neonatal deaths due to complication of prematurity. The study concluded that newborn resuscitation training reduces neonatal deaths by 30%.

Topyian, A.A., et al. (2010) stated resuscitation training in developing countries, increaesd child survival after resuscitation training, with an absolute risk reduction that ranges from 0% – 34%. Further stated that training in developing countries has significantly improved the knowledge and practice of health professionals by reducing the mortality rate.

Jukkala, A.M., & Henly, S.J (2009) conducted a correlational study on provider readiness for newborn resuscitation among nurses and physician working in rural hospital, USA. The samples were 165 nurses and 59 physicians. Correlation between frequency of skill performance and comfort was higher for nurses than physicians. The study revealed that nurses had significant higher average level of comfort, knowledge and experience.

Zaeem-ul-Haq., et al. (2009) conducted a postal survey on evidence for improvement in the quality of care among nurses and doctors from public sector hospitals Islamabad. 90% of the samples reported the use of acquired skills and the structured airway, breathing and circulation approach in handling emergencies. The study concluded that introducction of training program in a resource constrained health care system had improved the emergency management of newborn.

Berger, T.M., & Pilgrims. (2009) stated almost 10% of all newborn need some form of respiratory assistance after birth, only 1% will need more advanced form of resuscitation. Because these rare events cannot be always anticipated. Pediatricians and neonatologists may not be readily available and resuscitation has to be performed by nurses.

Surg. Cdr S & Narayanan., et al. (2009) conducted one group pre test and post test design to evaluate the effectiveness of teaching of newborn resuscitation for medical personnel including nursing officers and probationers nurses. The mean pre test score was 9.03 which improved to a mean of 15.53 in post test.

Bream, K.D. (2005) conducted a study to assess barriers to and facilitators for newborn resuscitation among nurses in a central hospital in Malawi. The study concluded that solution to barriers included small resources additions as well as term policy changes. With standard protocols, experienced confident nurse could overcome the barriers in providing newborn resuscitation so that it can reduce infant mortality and improve the quality of life of women receiving care in Malawi.

Mc.Namara, P.J. (2002) conducted a comparative study on resuscitation and stabilization of premature infants when specialized neonatal retrieval team is in attendance at delivery with immediate resuscitation performed by the referral hospital team. Results showed that the presence of highly skilled transport team at a high risk preterm delivery improves the quality of newborn resuscitation.