Care Practices of the Term, Well-Appearing Newborn Delivered to a Mother Diagnosed with Chorioamnionitis as Reported by Nurses in Virginia Hospitals 194 views

A newborn delivered to a mother who has been diagnosed with chorioamnionitis is frequently separated from the mother shortly after birth for a period of time ranging from minutes to days as a result of national recommendations to collect lab work and start empiric antibiotics. Studies show there is wide variation in adherence to this guideline when the newborn is term and well-appearing. The purpose of this study was to describe the impact of a maternal diagnosis of chorioamnionitis on the care practices of term, well-appearing newborns delivered in Virginia hospitals. The primary investigator designed and administered a survey to nurses in clinical leadership roles working in 51 level I newborn nurseries in Virginia to describe the care practices of comfort, feeding, and monitoring, as derived from the Universe of Developmental Care. Of the 23 responses from 23 unique hospitals throughout Virginia, over 80% frequently or always allowed newborns in this population to have at least the first hour of life skin-to-skin (STS) with the mother (81.8%), have the first breastfeeding prior to any separation for sepsis screening (81.8%), and to room-in (82.6%). Newborns in this sample were rarely or never separated from the mother for monitoring in the NICU (56.3%) or nursery (52.7%), but most were monitored more closely than newborns receiving routine newborn care by frequently or always receiving more frequent vital signs (75%) and nursing assessments (65%). Although there was variation, the majority of hospitals sampled rarely or never collected lab work in the mother’s room (40.9) or administered antibiotics in the mother’s room (47.8). When compared with care practices described through national and other regional studies, the Virginia hospitals in this sample described frequent use of care practices that protect the term, well-appearing newborn’s unique needs when delivered to a mother diagnosed with chorioamnionitis. More study is needed to determine an evidence-based approach to caring for this population of newborns.

DNP (Doctor of Nursing Practice)

newborn; early-onset sepsis; chorioamnionitis

English

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2019-04-29