Implementing a comprehensive newborn monitoring chart: Barriers, enablers, and opportunities.

Documenting inpatient care is largely paper-based and it facilitates team communication and future care planning. However, studies show that nursing documentation remains suboptimal especially for newborns, necessitating introduction of standardised paper-based charts. We report on a process of impl...

Full description

Bibliographic Details
Main Authors: Naomi Muinga, Ibukun-Oluwa Omolade Abejirinde, Lenka Benova, Chris Paton, Mike English, Marjolein Zweekhorst
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2022-01-01
Series:PLOS Global Public Health
Online Access:https://doi.org/10.1371/journal.pgph.0000624
_version_ 1797699917613891584
author Naomi Muinga
Ibukun-Oluwa Omolade Abejirinde
Lenka Benova
Chris Paton
Mike English
Marjolein Zweekhorst
author_facet Naomi Muinga
Ibukun-Oluwa Omolade Abejirinde
Lenka Benova
Chris Paton
Mike English
Marjolein Zweekhorst
author_sort Naomi Muinga
collection DOAJ
description Documenting inpatient care is largely paper-based and it facilitates team communication and future care planning. However, studies show that nursing documentation remains suboptimal especially for newborns, necessitating introduction of standardised paper-based charts. We report on a process of implementing a comprehensive newborn monitoring chart and the perceptions of health workers in a network of hospitals in Kenya. The chart was launched virtually in July 2020 followed by learning meetings with nurses and the research team. This is a qualitative study involving document review, individual in-depth interviews with nurses and paediatricians and a focus group discussion with data clerks. The chart was co-designed by the research team and hospital staff then implemented using a trainer of trainers' model where the nurses-in-charge were trained on how to use the chart and they in turn trained their staff. Training at the hospital was delivered by the nurse-in-charge and/or paediatrician through a combined training with all staff or one-on-one training. The chart was well received with health workers reporting reduced writing, consolidated information, and improved communication as benefits. Implementation was facilitated by individual and team factors, complementary projects, and the removal of old charts. However, challenges arose related to the staff and work environment, inadequate supply of charts, alternative places to document, and inadequate equipment. The participants suggested that future implementation should be accompanied by mentorship or close follow-up, peer experience sharing, training at the hospital and in pre-service institutions and wider stakeholder engagement. Findings show that there are opportunities to improve the implementation process by clarifying roles relating to the filing system, improving the chart supply process, staff induction and specifying a newborn patient file. The chart did not meet the need for supporting documentation of long stay patients presenting an opportunity to explore digital solutions that might provide more flexibility and features.
first_indexed 2024-03-12T04:14:47Z
format Article
id doaj.art-36ca45a15bb8430b8e79e49fa5c94862
institution Directory Open Access Journal
issn 2767-3375
language English
last_indexed 2024-03-12T04:14:47Z
publishDate 2022-01-01
publisher Public Library of Science (PLoS)
record_format Article
series PLOS Global Public Health
spelling doaj.art-36ca45a15bb8430b8e79e49fa5c948622023-09-03T10:39:46ZengPublic Library of Science (PLoS)PLOS Global Public Health2767-33752022-01-0127e000062410.1371/journal.pgph.0000624Implementing a comprehensive newborn monitoring chart: Barriers, enablers, and opportunities.Naomi MuingaIbukun-Oluwa Omolade AbejirindeLenka BenovaChris PatonMike EnglishMarjolein ZweekhorstDocumenting inpatient care is largely paper-based and it facilitates team communication and future care planning. However, studies show that nursing documentation remains suboptimal especially for newborns, necessitating introduction of standardised paper-based charts. We report on a process of implementing a comprehensive newborn monitoring chart and the perceptions of health workers in a network of hospitals in Kenya. The chart was launched virtually in July 2020 followed by learning meetings with nurses and the research team. This is a qualitative study involving document review, individual in-depth interviews with nurses and paediatricians and a focus group discussion with data clerks. The chart was co-designed by the research team and hospital staff then implemented using a trainer of trainers' model where the nurses-in-charge were trained on how to use the chart and they in turn trained their staff. Training at the hospital was delivered by the nurse-in-charge and/or paediatrician through a combined training with all staff or one-on-one training. The chart was well received with health workers reporting reduced writing, consolidated information, and improved communication as benefits. Implementation was facilitated by individual and team factors, complementary projects, and the removal of old charts. However, challenges arose related to the staff and work environment, inadequate supply of charts, alternative places to document, and inadequate equipment. The participants suggested that future implementation should be accompanied by mentorship or close follow-up, peer experience sharing, training at the hospital and in pre-service institutions and wider stakeholder engagement. Findings show that there are opportunities to improve the implementation process by clarifying roles relating to the filing system, improving the chart supply process, staff induction and specifying a newborn patient file. The chart did not meet the need for supporting documentation of long stay patients presenting an opportunity to explore digital solutions that might provide more flexibility and features.https://doi.org/10.1371/journal.pgph.0000624
spellingShingle Naomi Muinga
Ibukun-Oluwa Omolade Abejirinde
Lenka Benova
Chris Paton
Mike English
Marjolein Zweekhorst
Implementing a comprehensive newborn monitoring chart: Barriers, enablers, and opportunities.
PLOS Global Public Health
title Implementing a comprehensive newborn monitoring chart: Barriers, enablers, and opportunities.
title_full Implementing a comprehensive newborn monitoring chart: Barriers, enablers, and opportunities.
title_fullStr Implementing a comprehensive newborn monitoring chart: Barriers, enablers, and opportunities.
title_full_unstemmed Implementing a comprehensive newborn monitoring chart: Barriers, enablers, and opportunities.
title_short Implementing a comprehensive newborn monitoring chart: Barriers, enablers, and opportunities.
title_sort implementing a comprehensive newborn monitoring chart barriers enablers and opportunities
url https://doi.org/10.1371/journal.pgph.0000624
work_keys_str_mv AT naomimuinga implementingacomprehensivenewbornmonitoringchartbarriersenablersandopportunities
AT ibukunoluwaomoladeabejirinde implementingacomprehensivenewbornmonitoringchartbarriersenablersandopportunities
AT lenkabenova implementingacomprehensivenewbornmonitoringchartbarriersenablersandopportunities
AT chrispaton implementingacomprehensivenewbornmonitoringchartbarriersenablersandopportunities
AT mikeenglish implementingacomprehensivenewbornmonitoringchartbarriersenablersandopportunities
AT marjoleinzweekhorst implementingacomprehensivenewbornmonitoringchartbarriersenablersandopportunities