Assessment of quality of care for children in selected hospitals in ...

Assessment of quality of care for children in selected hospitals in Ghana8.4 Case management and sick newborn careNote: Sick newborns might be admitted in different areas, the maternity ward or the infant ward.Information should be primarily by case observationStandardsNeonatal sepsis is appropriately diagnosed and investigatedNeonatal sepsis is adequately treatedSpecific feeding needs of sick young infants and those with low birth weight are taken care ofSevere jaundice is recognized and appropriately managedStandards and criteriaGoodTo beimprovedCommentsDiagnosis and investigation of neonatal sepsisNeonatal sepsis is suspected in neonates withsigns such as fever or difficulty feeding andappropriately investigated (e.g. urinemicroscopy, foci of infection) pp 47, 53.Lumbar puncture is done to rule out/confirmmeningitis pp 49,50,316.Newborns receive oxygen if cyanosed or insevere respiratory distress p 52.Treatment of neonatal sepsisEffective antibiotics are given according to ageand weight of the baby p 49‐50,62‐66. The response to treatment is monitored p 48. Specific feeding needs of sick young infants and those with low birth weightAll efforts are made to give mother’s milk toLBW babies p 53‐55.Frequent feedings (at least 8 x per day) areprovided to LBW‐babies and intake ismonitored p 54.To children unable to feed expressed breast milkis given by cup and spoon or fed by nasogastrictube in adequate amounts according to age.Intake is monitored p 55.If IV‐fluids are given, they are recorded andprecautions are in place to prevent fluidoverload p 51,52.In LBW‐babies, heat loss is minimized bykangaroo‐care and a cap on the head p 54.Recognition and management of jaundiceFacilities for exchange transfusion are available,or there are guidelines when to refer a childp 58.Page 96