Article Text
PDF
Abstract
Aims Neonatal mortality has improved greatly in line with MDG4 but remains a major global challenge. Studies in Africa show prevalence of neonatal hypothermia of up to 85%, associated with increased mortality. Parents are an important resource in Low Income Settings, and peer counsellors have proven efficacy in other studies. We hypothesised that empowering parents to monitor their newborn’s temperatures with the assistance of a designated Parent Temperature Champion would enable better thermal control and improve outcomes.
Methods A temperature chart was introduced to the Neonatal Unit at Jinja Regional Referral Hospital in November 2014 (Figure 1). Parents were taught to use thermometers, record temperatures, and treat hypothermia, overseen by a Parent Temperature Champion. We retrospectively audited notes of babies with a birth weight <2kg admitted during 2 months before this intervention (n = 45), and 2 months after (n = 36).
Results We found a significant increase in the average temperature from 36.28oC to 36.43oC (p < 0.01) (Figure 2). Average numbers of temperatures recorded per day of admission also increased (1.2 temperatures taken per day to 1.9, p < 0.001). The percentage of temperatures which were severely hypothermic (≤34.9oC) reduced significantly from 8.9% to 2.8% (p < 0.0001). Similarly, the percentage of temperatures which were moderately or severely hypothermic (≤35.9oC) decreased significantly from 27.9% to 19.9% (p < 0.01). However, the percentage of temperatures showing any degree of hypothermia (≤36.4oC) remained the same (48% to 44%, p = 0.27) (Figure 3). The percentage of days of admission with severe hypothermia (≤34.9oC) reduced from 8.1% to 4.6% (p < 0.07), however this trend did not reach statistical significance. The number of deaths, discharges and “runaways” did not change significantly.
Conclusion The introduction of a caretaker-completed temperature monitoring chart with a Parent Temperature Champion has resulted in a highly significant increase in the average temperature and number of temperatures recorded, and a decrease in moderate and severe hypothermia in neonates below 2kg.