Area of improvement | n (%) | Change ideas tested | n | % |
---|---|---|---|---|
Medical equipment and supplies | 2 (28.6 %) | Prevent stockout of medicines (such as aminophylline) | 1 | 14.3 % |
Avail sheets for covering babies | 1 | 14.3 % | ||
Monitor emergency ambulance kit (medicines) and ensure its completeness for newborns and maternity cases | 1 | 14.3 % | ||
Avail Personal Protective Equipment (shoes and gowns) for infection prevention and control in NCU | 1 | 14.3 % | ||
Capacity building for NCU staff | 5 (85.7 %) | Training of NCU staff on clinical care in neonatal units according to NCU protocol | 5 | 71.4 % |
Training staff on how to use equipment in the NCU | 2 | 28.6 % | ||
Training of staff on infection prevention and controll for neonatal units | 1 | 14.3 % | ||
Training on managing infants with feeding difficulties | 2 | 28.6 % | ||
Sensitize on close monitoring of newborns | 1 | 14.3 % | ||
Improve monitoring in NCU | 1 | 14.3 % | ||
Documentation | 1 (14.3 %) | Proper documentation of fluids electrolytes and nutritional adjustments by medical doctors and nurses | 1 | 14.3 % |
Caregiver Engagement in Newborn Care | 3 (42.9 %) | Involve caregivers in care using danger signs tracking sheet | 1 | 14.3 % |
Use an “Expert Mom” role model to provide support to other mothers for breastfeeding, KMC, nad observing for danger signs | 1 | 14.3 % | ||
Task shifting to mothers for hypothermia monitoring by hand with alerts to nurses for temperature taking | 1 | 14.3 % | ||
Task shifting to mothers for ensuring on-time feeding newborns in NCU after 3 days support by NCU staff | 1 | 14.3 % | ||
Caregiver/client Social Support | 1 (14.3 %) | Provide porridge to moms in the NCU | 1 | 14.3 % |
Behavior Change Communication (BCC) | 5 (85.7 %) | Health education to mothers of babies admitted in NCU on nutrition, breastfeeding, feeding, prevention of hypothermia, danger signs, KMC, hygiene, etc. | 4 | 57.1 % |
Visual reminders on clocks/watches for feeding newborns | 1 | 14.3 % | ||
Process monitoring | 2 (28.6 %) | Routine check of vital sign completion | 1 | 14.3 % |
Conduct preterm death audit | 1 | 14.3 % | ||
Protocol Adherence | 7 (100 %) | Regular monitoring of vital signs several times per day | 5 | 71.4 % |
Adherence to protocol with regards to neonatal feeding and nutritional adjustment | 3 | 42.9 % | ||
Daily accurate weight measurement | 2 | 28.6 % | ||
Check-up for glycemia and temperature (for preterm babies) within 30 min of admission to the NCU | 1 | 14.3 % | ||
Regular monitoring of newborn weight gain | 1 | 14.3 % | ||
Monitoring of feeding practices | 2 | 28.6 % | ||
Change IV lines every 3 days | 1 | 14.3 % | ||
Staffing | 2 (28.6 %) | Have the same medical doctor rounding in NCU for 3 consecutive days per week | 2 | 28.6 % |
Increase staff assigned to work in NCU | 1 | 14.3 % | ||
Appoint permanent staff to NCU (Separating NCU from Maternity) | 1 | 14.3 % | ||
Interfacility Communication | 1 (14.3 %) | Health Center communicates the case to hospital NCU by phone call prior to reference of a neonate | 1 | 14.3 % |
Teamwork | 4 (57.1 %) | QI Team meeting to track the progress of the project | 4 | 57.1 % |
Joint meeting with maternity staff to discuss care of preterm newborns | 2 | 28.6 % | ||
Infection Prevention and Control | 2 (28.6 %) | Improve handwashing | 1 | 14.3 % |
Use of alcohol while on ward rounds for everyone | 1 | 14.3 % | ||
Regular staff deep cleaning of the NCU through “Umuganda” | 1 | 14.3 % | ||
Hygiene of incubators | 1 | 14.3 % | ||
Infrastructure Improvement | 2 (28.6 %) | Relocating NCU to larger existing spaces for improved flow of care | 2 | 29 % |