Co-design and evaluation of improved information tools to support better monitoring of inpatient newborn care

Project Details


Problem statement
Care for sick newborns is typically provided by multi-professional teams that are required to adhere to best practises and these babies could spend many days in the neonatal unit. While care is often planned by a team of clinicians, nurses are the primary care givers in newborn units and thus accurate documentation of nursing care and patient progress plays an important role in both provision of quality care and team communication. However, little attention has been paid to job aids that nurses use to record the monitoring care given to admitted newborns. Preliminary data obtained from newborn units of hospitals that are a part of a network of hospitals in Kenya revealed that for both vital signs monitoring and feed and fluid prescription and monitoring, there is a diversity of forms in use and all are sub-optimal. Challenges with the existing forms include: different combination and order of fields, different ways of filling the same field (e.g. urine output – use of a tick or cross to indicate presence of urine) and inadequate fields leading to improvisation. This variation in forms used to document nursing care can lead to inefficient documentation, duplication of data, improvisation by health care workers and poses an informatics challenge when it comes to computerization of clinical records[1].

Relevance of the study and embeddedness within existing literature
Observations by nurse administrators in Kenya revealed that documentation of nursing care faced major challenges making it a priority area for improvement[2]. In addition, recent work on defining standards for neonatal care identified better tools to document nursing observations to facilitate more rapid, accurate, and informative communication between nurses and with other professionals as a key part of improving quality of care[3]. For the newborn, vital signs monitoring and how abnormalities are identified, and action triggered are a priority and effective management of neonatal fluid intake and nutrition is also critical. Therefore, monitoring progress is important for safety reasons and ensuring that newborns not only survive but also thrive. For these reasons, it is therefore important to develop tools to facilitate efficient monitoring of nursing care.

Objectives and methodology
The overall aim of the study is to co-design and evaluate improved vital signs and feeds and fluids and monitoring tools to support better inpatient newborn care in Kenyan hospitals as part of emerging efforts to strengthen and increasingly digitize health information systems in Kenya. A human-centered approach that focuses on understanding the user and the context to will be adopted in developing these tools through co-design workshops and prototyping
Effective start/end date17/04/20 → …

IWETO expertise domain

  • B680-public-health