Efficacy of a discharge checklist for neonates in reducing neonatalmorbidity and mortality

Abstract

Introduction: In 2015, almost 1 million child deaths occurred in the first day of life while about 2 million deaths occurred in the first week. Most of these deaths are readily preventable or treatable with proven, cost-effective interventions like a checklist to reduce neonatal morbidity and mortality.
Objective: The primary objective was to determine the efficacy of a standardized neonatal discharge checklist on the rate of  hospitalization during the neonatal period at the Kenyatta National Hospital. The specific objective was to determine the acceptability of a structured postnatal discharge checklist among health care workers at Kenyatta National Hospital.
Study design setting and population: A mixed method study that included the Quasi-experimental pre- post intervention design and focus group discussion on nurses was carried out in the post-natal wards at Kenyatta National Hospital. Neonates with no complications were enrolled for the study after consent was obtained.
Methodology: Qualitative and quantitave methods were incorporated in this study. Structured questionnaires were administered to mothers in the postnatal ward and trained nurses on the checklist. Qualitative data was obtained using focus group discussions.
Results: There was a trend noted for reduced hospitalization following introduction of the neonatal discharge checklist from 7.4% to 3.2% in the pre intervention and post intervention respectively a 56.7% reduction in hospitalization (p=0.06). There was significant improvement in knowledge on cord cleaning after the intervention (p =<0.001) as well as on identifying newborn danger signs  (p=0.005).
Conclusion: There was a trend for reduced hospitalization following implementation of the neonatal discharge checklist.