Assessment of Hypothermia and the Thermoregulation measures received by neonates of a selected Medical College and Hospital, West Bengal

Abstract

Hypothermia is a significant cause of neonatal morbidity and mortality in developing countries like India and it is associated with variety of causes and many of which are preventable. An exploratory survey study was conducted for assessing the hypothermia and thermoregulation measures received by neonates of selected Medical college and hospital, WB. The purpose of the study was to identify the occurrence of hypothermia and the thermoregulation measures received by neonates. Through purposive sampling 61 neonates who were born vaginally, greater than 37 weeks of gestation and birth weight 2.5–3.5kg were recruited for the study. The tools used in this study were semi-structured interview schedule, digital thermometer, and structured observation checklist. Validity and reliability of tools were established before data collection. Collected data were finally analyzed using descriptive and inferential statistics. Findings of this study revealed that there is 32.78% occurrence of mild hypothermia in five time observation from birth to next four hours, even they all were full term healthy neonates. There was no evidence of moderate and severe form of hypothermia throughout the assessment period. Few immediate measures of thermoregulation which were 100% maintained by delivery room staffs i.e. closing door and windows of delivery room, radiant warmers on 30 min before delivery of a baby, prewarm two sheets were kept ready before delivery. Rest thermoregulation measures received by neonates were received neonates in prewarm sheet 60.7%, wrapped neonate with another pre warm sheet 70.5%, delay cord clamping was done for only 47.50% neonates, uninterrupted skin to skin (STS) contact with mother for one hour 59%, weighing after one hour STS for only 34.40% and early initiation for breast feeding was for 63.90% neonates. Thermoregulation measures during transportation like transportation with full cover of head, body and extremities and transportation with STS with mother received 70.49% and 57.38% of neonates. On the other hand 100% thermoregulation measures were maintained in postnatal ward like maintaining temperature of postnatal ward above 25°C, put off fans and closed doors and windows on the head side of neonates whereas few more thermoregulation measures like kept the neonates full cover only face expose was maintained for 54.1%, touch the neonates were touches with dry hands72.1%, changed soil napkin immediately73.8%. The mothers of 86.9% of neonates provided breast feeding in every two hours or on demand in postnatal ward whereas in second and third observations interval of breastfeeding maintained for 70.5% and 83.5% of neonates. Selected factors of thermoregulation such as temperature of delivery room, temperature of post natal ward, uninterrupted skin to skin contact with mother for one hour, warm transportation with full cover of head, body and extremities of neonates significantly associated with hypothermia. The findings of this study have several implications in the field of nursing because thermoregulation measures which can prevent neonatal hypothermia is very important aspect of newborn care.