Comparison of Umbilical Cord Cleansing Using Sterile Water and Povidine Iodine- Spirit During Early Neonatal Period: A Double Blind Randomized Control Trial

Chawla, Gautam; Diwakar, K. K.

doi:10.7860/jcdr/2015/13562.6162

Cited by 6 publications

(3 citation statements)

References 7 publications

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“…However, further analysis could not be carried out. A study by M. Takrouri et al suggests changing the IV cannula every 48 hours to prevent colonization and further infection to the patient, 51 but our study finds a frequent change in IV cannula poses a higher risk to neonatal HAIs. Although umbilical catheters had no significant association with HAIs, changing the central venous catheter/umbilical catheter every 10 days or less to prevent HAIs may have a better outcome.…”

Section: Discussioncontrasting

confidence: 76%

“…Although umbilical catheters had no significant association with HAIs, changing the central venous catheter/umbilical catheter every 10 days or less to prevent HAIs may have a better outcome. 51 Different therapeutic procedures, both invasive and non-invasive, significantly contribute to neonatal HAIs as per the large multicentre study of the German Neonatal Network. 52 To curb the development of HAIs, it is necessary to reduce the number of procedures, duration of invasive and non-invasive procedures, especially to neonates born due to premature labor and very low birth, as they pose a higher risk of acquiring HAIs.…”

Section: Discussionmentioning

confidence: 99%

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Preventable contributors to the neonatal healthcare-associated infections: a uni-center analytical study from South India.

Rani

Lewis²,

Chawla

et al. 2022

F1000Res

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Background: Globally, neonatal healthcare-associated infections (HAIs) are known to cause high mortality. HAIs is a preventable condition related to the healthcare environment. The current study explored the contributors to neonatal HAIs in one of the largest tertiary care referral hospitals in South India. Methods: Neonates from December 2016 to June 2018 were observed for the occurrence of healthcare-associated infections and compared with the matched control group. Various observations on neonatal demography, maternal contributors, and medical procedures were made and recorded to explore and analyse the contributors to neonatal HAIs. Univariate and multivariate analysis was carried out to find the contributors. The Odds ratio with 95% CI was also computed and reported. Results: Bloodstream infection (83%) was prevalent among neonates; the maternal contributor was only preterm labor (Odds ratio of 11.93; 95% CI; 6.47-21.98; p<.05) to acquire HAIs. On univariate analysis, mechanical ventilation for > 3days duration, NIV for > five days, and PICC line insertion procedure were significant (p<0.05) contributors to neonatal HAIs. IV cannulation for more than three times in four consecutive days was found in 100(85%) neonates considered being associated with neonatal HAIs. On multivariate analysis, NIV, PICC line, preterm labor, and low birth weight were significant (p<0.05) contributors to neonatal HAIs. Conclusion: The increased duration of invasive and non-invasive therapeutic devices and catheters contributes to neonatal HAIs. Neonates are acquiring bloodstream infections; low birth weight (LBW) neonates are more susceptible to acquiring HAIs.

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Section: Discussioncontrasting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Preventable contributors to the neonatal healthcare-associated infections: a uni-center analytical study from South India.

Rani

Lewis²,

Chawla

et al. 2022

F1000Res

View full text Add to dashboard Cite

show abstract

“…23 Developed countries have shown better outcomes after quality initiatives in NICU as compared with developing or resource-limited settings. 14 Few practices help to reduce BSI or CLABSI like the use of chlorhexidine coated IV cannula stopper 60 or single-use sterile tray for medication preparation and delivery, 61 cord care and neonatal bathing with chlorhexidine, 62,63 dedicated nurse leader for monitoring and training on infection control practices. 64 These practices help but do incur a cost burden on the healthcare organization and family of the neonate where out of pocket expenses on hospitalization drain out their entire savings.…”

Section: Discussionmentioning

confidence: 99%

Development and evaluation of prevention bundle for neonatal healthcare-associated infections: an interventional study

et al. 2023

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Background: Neonatal healthcare-associated infection (HAI) globally is the leading preventable cause of neonatal mortality. Neonatal mortality in India is also very high. Considering that HAIs can be prevented globally, there are disparities in resources; the current study aimed at developing locally feasible and effective prevention bundles for neonatal HAIs. Methods: A mixed-method study was conducted at one tertiary care teaching hospital's level IV Neonatal Intensive Care Unit. The study explores the causes of neonatal HAIs, current processes, benchmark practices, gaps in current practices with HAIs, root-cause analysis and system process mapping, and failure mode effect analysis. Observations, interviews, brainstorming activities, and a survey were conducted. Written and audio-video recorded prevention bundle was developed and implemented using a quasi-experimental study design. Results: Process standardisation, healthcare worker training, hand hygiene practices, nursing care process and vascular access process were identified as key improvement areas to prevent neonatal HAIs. Out of eighteen identified processes, three processes were standardised. All the healthcare providers were trained at three-time intervals of three months each. After implementing the prevention bundle, there was a significant decline in the rate of HAIs, reducing it from 9.6 to 7.0 per 100 admissions >48 hours. The bacteraemia rate fell from 5.2 per 1000 patient days to 2.6 per 1000 patient days and was statistically significant on a two-tailed student t-test with 95% CI with p-value=0.00073. Conclusions: Our developed prevention bundle for neonatal HAIs was significantly effective and reproducible for healthcare workers' training and development. Considering variations in global infection control practices and resources constraint, it is effective to develop a local prevention bundle for neonatal HAIs.

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Cultural patterns and outcome of umbilical cord care among caregivers in Africa: a systematic review

Abua,

Antor Odu,

Madubuattah

et al. 2023

Annals of Medicine &Amp; Surgery

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Background: The third leading cause of death in infants under 1-month-old is neonatal sepsis. Following the severing of the umbilical cord, bacterial infection may result in newborn sepsis and mortality. The objective of this review on cultural patterns and umbilical cord-care outcomes is to evaluate present practices and create a case for developing and implementing novel cord-care regimens in Africa. Materials and methods: In order to find published studies on cultural patterns and outcomes of umbilical cord care among caregivers in Africa from January 2015 to December 2021, we conducted a systematic literature search across six computerized bibliographic databases: Google Scholar, POPLINE, PubMed, Web of Science, Science Direct, and Scopus. As a result, a narrative synthesis of quantitative and qualitative data was employed to summarize the data from the included research. Results: There were 17 studies included in this review with 16 out of the 17 studies having a total of 5757 participants. The odds of neonatal sepsis were 13 times higher among infants whose caregivers had improper hygiene compared with those who had proper hygiene. The outcome of cord management showed that the majority (75.1%) of the umbilical cords were infected. Majority of the included studies (n=13) show that the respondents (caregivers) had a low level of knowledge and practice. Conclusion: This systematic review reveals that unsafe umbilical cord-care practices remained prevalent in some African regions. Home delivery is still a prevalent practice in some communities and inappropriate umbilical cord cleaning practices were common findings.

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Comparison of Umbilical Cord Cleansing Using Sterile Water and Povidine Iodine- Spirit During Early Neonatal Period: A Double Blind Randomized Control Trial

Cited by 6 publications

References 7 publications

Preventable contributors to the neonatal healthcare-associated infections: a uni-center analytical study from South India.

Preventable contributors to the neonatal healthcare-associated infections: a uni-center analytical study from South India.

Development and evaluation of prevention bundle for neonatal healthcare-associated infections: an interventional study

Cultural patterns and outcome of umbilical cord care among caregivers in Africa: a systematic review

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