Obstetric Ward Research Articles

“If-then”-scenarios in the care of pregnant women with diabetes in socially vulnerable positions

Abstract Background Pregnant women with diabetes in socially vulnerable positions face a multiplicity of medical, social, and psychological risks during pregnancy and birth and are susceptible to health inequities. This presentation explores the tentative nature of care provided to these women. Methods We base our findings on ethnographic fieldwork among health professionals at an obstetric outpatient clinic in Denmark. Results The unpredictability of diabetes during pregnancy calls for a flexible approach to treatment, placing significant demands on health professionals, pregnant women, and their partners and their ability to adjust to new scenarios. Our initial findings underscore that care is not static; it is dynamically adjusted to meet the medical, social, and psychological needs of the women. The adjustments in care encompass the negotiation and monitoring of insulin dosages, fetal weight, appointment frequencies, and additional consultations and impromptu phone consultations to follow up. An example of the tentativeness in care could be that if there is a sudden decrease in insulin requirements close to the due date then the birth might be induced. Beyond medical monitoring and treatment, the care extends to social initiatives that the health professionals must coordinate with various municipalities, depending on where the pregnant women live. This could include a joint meeting after the delivery between the woman, her partner, a health professional from the obstetric ward, and a social worker from the municipality. Often, this meeting is mentioned during consultations and intersectional meetings before the birth but is not formally arranged. Instead, it is tentative - if the pregnant woman would like a meeting upon discharge, then the health professional will set up a meeting. Conclusions Medical, social, and psychological care practices for women with diabetes in socially vulnerable positions are replete with “if-then” scenarios. Key messages • Care for pregnant women with diabetes in socially vulnerable positions is characterized by its fluidity and flexibility adjusting to the interplay of medical, social, and psychological needs. • The “if-then” scenarios that characterize the care for pregnant women with diabetes in socially vulnerable positions put high demands on the ability to adapt and adjust continuously.

Virulence Potential of ESBL-Producing Escherichia coli Isolated during the Perinatal Period.

The aim of the study was to investigate the virulence factors in Escherichia coli producing extended-spectrum β-lactamase (ESBL) derived from the perinatal fecal colonization flora of mothers and their newborns in a Chinese obstetric ward. Rectal swabs were obtained from mothers prenatally and from their newborns postnatally, and analyzed for ESBL-producing Escherichia coli. The isolates were then whole-genome sequenced. Maternal and neonatal colonization by ESBL-producing E. coli in a Chinese obstetric ward was 18% (31/177) and 5% (9/170), respectively. Fecal ESBL-producing isolates exhibited a significantly lower frequency of virulence factors compared with invasive E. coli. Providing balanced information on screening results is essential, along with conducting a risk assessment for antibiotic treatment strategies. · High ESBL E. coli colonization rates in mothers and neonates perinatally. · Fecal ESBL-producing E. coli showed fewer virulence traits.. · ESBL-producing E. coli knowledge may prompt antibiotic overuse..

The maternity dashboard is an effective tool for the improvement of maternal and neonatal care outcomes: a prospective observational study from Iraq

Background: The implementation of maternal dashboards in hospitals is both feasible and effective in improving healthcare quality. The dashboards provide rapid feedback on local outcomes in an accessible format and enable early detection of potential problems. They serve as a simple computerized tool that graphically presents the health facility’s clinical data, utilizing a traffic-light coding system so as to alert front-line staff about changes in the frequency of clinical outcomes. Aim: The aim of this study was to assess the effectiveness of the maternity dashboard in improving maternal health, reducing Neonatal Intensive Care Unit (NICU) admissions, as well as enhancing maternal and neonatal outcomes in an Iraqi hospital. Methodology: Data were collected over one year, from January 1st to December 30th, 2023. A prospective observational study (hospital-based record review) was conducted at the Obstetrics and Gynaecology Teaching Hospital in Kerbala, Iraq. Data were obtained from the medical records of all patients admitted to the obstetrical ward for labor, delivery, and the postpartum period during 2023. The maternal dashboard, a traffic light program (green, amber, red), was used in order to monitor outcomes. Data were collected manually from the outpatient department, the labor ward, the NICU registers, and the electronic records by using Excel. Results: A total of 136,519 women (who were either pregnant, in labor, or postpartum for up to 42 days) were admitted to the Obstetrics and Gynaecology Teaching Hospital in Kerbala during the study period, with 18,791 of them delivering. The implementation of the maternity dashboard resulted in significant changes: the normal vaginal delivery rate increased from 66% to 68% (p=0.0024), the caesarean section rate decreased from 33% to 31% (p=0.0001), the stillbirth monthly cases declined from 16±5 to 12±3 (p<0.05), the NICU admission monthly instances decreased from 96±14 to 71±17 (p<0.05), and early neonatal death monthly cases were reduced from 12±5 to 9±3 (p<0.05). Conclusion: The study results show that maternity dashboards are vital instruments for monitoring and improving the quality of maternity care. They effectively enhance maternal and neonatal care quality indicators when comparing results before and after their implementation.

Psychometric properties of the generalized anxiety disorder questionnaire (GAD-7) in a polish postpartum women sample

ObjectiveGeneralized Anxiety Disorder is an international mental health problem. Prevalence for anxiety disorders reported in perinatal period is high and related with adverse parental and child outcomes. Thus, the objective of this study was to investigate the psychometric properties and factorial validity of General Anxiety Disorder-7 questionnaire (GAD-7) in the context of postpartum mothers.MethodsIn this cross-sectional study, 278 mothers (mean age 31.09; SD = 4.42) were recruited at the Neonatology, Gynecology, and Obstetrics Ward. Generalized Anxiety Disorder was assessed with GAD-7, stress with Parental Stress Scale (PSS), while risk of depression with Edinburgh Postpartum Depression Scale (EPDS). Confirmatory factor analysis (CFA) was used to verify factor structure of GAD-7 and the internal consistency was evaluated using reliability coefficients: Cronbach’s Alpha and McDonald’s Omega.ResultsThe internal consistency of the GAD-7 was high (Cronbach’s Alpha = 0.90 and MacDonald’s Omega = 0.91). GAD-7 had significant correlations with the variables examined for construct validity, stress (PSS; r = 0.35, p < 0.01) and risk of depression (EPDS; r = 0.76, p < 0.01). The Confirmatory Factor Analysis results supported a good fit of the data to the model: χ²(df) = 14.19 (14), p = 0.44; Comparative Fit Index (CFI) = 0.99; Tucker-Lewis Index (TLI) = 0.99; Root Mean Square Error of Approximation (RMSEA) = 0.007 (90% C.I. 0.000; 0.059).ConclusionGAD-7 has satisfactory psychometric properties. GAD-7 had significant correlations with the variables examined for construct validity with PSS and EPDS. GAD-7 is a reliable instrument for screening anxiety symptoms in perinatal period in research and clinical setting.

A prospective blinded diagnostic accuracy study to assess the accuracy of fetal weight estimation at term by clinical method using Leopold’s maneuvers and ultrasonography in predicting the actual birth weight

ABSTRACT Context: Over-medicalization of normal pregnancy is associated with unnecessary inductions of labor leading to operative deliveries. In a busy outpatient department (OPD) or low-resource setup where ultrasound availability, experience, and cost will be a concern, routine ultrasound at term can be avoided if the clinical estimation of fetal weight is more or less equal to the actual birth weight. Aims: To assess the reliability and validity of fetal weight estimation at term by ultrasound and clinical estimation. Settings and Design: A prospective study of diagnostic accuracy was done over a period of 1.5 years in a tertiary hospital, which included 100 women with term singleton pregnancies admitted in obstetric wards or labor room. Methods and Material: To find out the agreement between actual birthweight and ultrasound fetal weight interclass correlation coefficient (ICC) was used. Mean difference plots (Bland–Altman plots) were done. The mean percentage error was compared with the consultant estimate and registrar estimate across groups. The sensitivity, specificity, and predictive values by clinical and ultrasound estimate were calculated for actual birth weight ≤ 2.5 kg. Results: Both methods of fetal weight estimation have moderate reliability in predicting the actual birth weight. The sensitivity of identifying birthweight &lt; 2.5 kg babies by ultrasound was slightly higher. For birth weight less than 2.5 kg, there was an overestimation of fetal weight by clinical estimation done by postgraduate with mean percentage error being statistically significant as compared with ultrasound estimation. Conclusions: In a developing country like ours where ultrasound is not readily available in all healthcare setups, the clinical method is an easy, cost-effective, simple one that can be used by all medical professionals after adequate training.

Next-generation monitoring in obstetrics: Assessing the accuracy of non-piezo portable ultrasound technology.

The emergence of handheld ultrasound devices capable of connecting to cell phones or tablets heralds a significant advancement in medical technology, particularly within the field of obstetrics. These devices offer the promise of immediate bedside ultrasound examinations, potentially revolutionizing patient care by enabling fetal assessments in diverse settings. This prospective study aimed to validate the reliability of non-piezo, chip-based handheld ultrasound devices in clinical obstetric practice. Conducted in a university hospital obstetric ward, the study included 100 pregnant women between 17 and 41 weeks of gestation. Participants underwent ultrasound examinations using both conventional and portable point-of-care ultrasound (POCUS) devices to compare the accuracy in estimating fetal weight and other parameters, such as cardiac activity, fetal presentation, placental location, and amniotic fluid volume. The reliability and agreement between the devices were assessed using intraclass correlation coefficients, Bland-Altman plots, and Pearson correlation coefficients. The results show a near-perfect agreement (0.98) and correlation (r = 0.98, p < 0.001) for estimated fetal weight and most biometry measurements between the two types of ultrasound devices, with slight deviations in head circumference and amniotic fluid index measurements. Subgroup analysis revealed variations in agreement and correlation rates with higher BMI and advanced gestational age, indicating areas for further refinement. These findings affirm the high reliability of handheld ultrasound devices for basic obstetric ultrasound evaluations, supporting their integration into daily clinical practice. This technology improves the flexibility and immediacy of prenatal care, although further research is needed to optimize its application across patient populations and treatment settings.

FREQUENCY OFANXIETY AND DEPRESSION AND ITS PSYCHOSOCIAL CORRELATES AMONG WOMEN RECEIVING ANTENATAL CARE IN A TERTIARY CARE HOSPITAL IN KARACHI

Objective: To determine the proportion of women suffering from antenatal depression and anxiety visiting a tertiary care hospital for routine antenatal visits to evaluate the psychosocial factors associated with their depression and anxiety. Study Design: A descriptive cross-sectional study Place and Duration Department of Gynaecology &amp; Obstetrics Ward 9B, Jinnah Postgraduate Medical Center (JPMC), Karachi from January 2024 to May 2024. Top of FormMethods: This study was conducted with 249 pregnant women via non-probability, consecutive sampling. Anxiety and depression were assessed using Urdu validated version of Hospital Anxiety and Depression Scale. Psychosocial stressors were also recorded. Data was entered and analyzed using SPSS for Windows version 23.0. Results: In this study, 20% of women in their second and third trimesters of pregnancies were anxious and 5% were depressed. Critical psychosocial factors included low education, marital stressors such as low social support from husband and/or in-laws, living separately from husband, and intimate partner violence, financial stressors such as husband unemployment and pregnancy-related factors such as unplanned pregnancy and narrow birth spacing. Conclusion: The study provides a significant burden of antenatal mental health issues in our region and their specific associated psychosocial factors. The study emphasizes upon the need for Biopsychosocial support systems and interventions to mitigate the risk of antenatal depression and safeguard maternal well-being during this critical period.

Accuracy of supervised measurement of fetal weight in a residency program.

To evaluate the accuracy of ultrasound estimates of fetal weight made by residents. A cross-sectional study was conducted on consecutive pregnancies attended in an obstetric ward. All participants provided their consent to participate. Inclusion criteria were singleton pregnancies with ultrasound evaluation and delivery within 14 days. Congenital abnormalities and stillbirths were excluded. Ultrasound scans were performed by two residents, one observer per subject, following standardized methodology and supervised by senior staff. Fetal weight was calculated using the four-parameter Hadlock 1985 formula. Birth weight was measured using a standard clinical scale. Bland-Altman and mixed-effects analyses were performed. In a 6-month period, 95 gestations were recruited at 30-41 weeks, and birth weights ranged from 1200 to 4080 g. The bias between methods was -28 g (CI95%, -74 to 18) with 95% limits of agreement of ±440 g. The 95% deviation between methods was of ±16%. Parity had the most significant effect on the bias between methods; operator and maternal weight had no significant effect. Supervised measurement of fetal weight by residents demonstrated high accuracy. Parity bias may be associated with visceral fat deposition independent of maternal weight gain. A methodology for medical evaluation is presented.

Management of Solid Medical Waste at Regional Public Hospital of West Papua Province

This study aims to characterize, identify and evaluate the management of solid medical waste in the West Papua Province Regional Public Hospital. This research is descriptive qualitative research conducted in December 2023 -January 2024 at the emergency room, obstetrics ward, pediatric ward, perinatology ward, surgical room, internal disease department and laboratory. The results research are the average amount of solid medical waste in West Papua Province Regional Public Hospital is 282.3 kg/month, consisting of infectious solid medical waste of 229 kg/month and the amount of infectious sharps medical waste of 53.3 kg/month. The process of solid medical waste management of hospitals in West Papua Province Regional Public Hospital has referred to the Government Regulation of the Republic of Indonesia Number 7 of 2019, although the results are not all appropriate.

The prevalence of erythrocyte alloimmunization in clinical practice: A hospital-based study

Abstract BACKGROUND: One of the complications of blood transfusion is the development of red cell alloimmunization. Little published literature on the prevalence and actual significance of red cell alloantibodies among nonregularly transfused patients and the general population. OBJECTIVES: This study aimed to estimate red cell alloantibodies’ prevalence, specificity, and clinical significance in obstetric and medical practice in Iraq. MATERIALS AND METHODS: A cross-sectional hospital-based study involving internal medicine patients and ladies in obstetric wards of Baghdad Teaching Hospital in Baghdad/Iraq, from January 2022 to May 2022. Demographic data were collected along with detailed medical, obstetric, and transfusion history. Alloantibody screening was performed, and samples with positive results were subjected to antibody titration and identification. RESULTS: A total of 200 patients were enrolled. Indirect antiglobulin test was positive in 15% of patients in internal medicine wards and 23% of ladies in obstetric wards, with most of the identified alloantibodies being clinically significant, against Kidd and Duffy antigen groups. Blood transfusion of more than four units to patients at internal medical wards showed a significant association as a risk for developing red cell alloantibodies (P = 0.025). For ladies in obstetric wards, there was a significant association between pregnancy loss at the time of screening and alloimmunization (P = 0.0164). CONCLUSION: High prevalence of red cell alloantibodies in comparison to what is published worldwide. Transfusion of more than four units of blood and pregnancy loss at the time of screening were statistically significant risks for alloimmunization of the medical and obstetric populations, respectively.

Motivational factors for dietary intake behavior in gestational diabetes mellitus: A cross-sectional study

ContextDecision-making behavior pertains to the cognitive process where a patient evaluates the advantages and disadvantages of health-related decisions, taking into account their personal preferences, values, and cognitive factors. This behavior is central to the successful implementation of clinical care. Effective decision-making enhances an individual's or organization's response to challenges and opportunities, improves problem-solving capabilities, reduces risks and uncertainties, and facilitates the attainment of desired outcomes. ObjectiveThe goal of this study was to investigate the current status of dietary choice decision-making in gestational diabetes mellitus and to analyze its influencing factors, and then to find the determining factors and give targeted nursing interventions in order to improve the dietary decision-making ability of gestational diabetes mellitus patients and further standardize their dietary patterns. MethodsA cross-sectional research design was employed in this study. Convenience sampling was utilized to survey 539 GDM patients attending the obstetrics outpatient clinic and obstetrics ward of a tertiary hospital in Wuxi City, China, from March 2023 to July 2023. The survey instruments used were the General Information Questionnaire, the Motivation to Protect Pregnant Women with Gestational Diabetes Mellitus Dietary Intake Questionnaire, and the Conflict in Decision-Making Scale. ResultsThe findings were derived from data collected from 539 GDM cases. The participants' ages ranged from 19 to 52 years, with a mean age of 31.53 ± 4.37 years. The scores for GDM disease perceived susceptibility were 15.200 ± 3.481, disease perceived severity 18.455 ± 4.670, internal reward 13.226 ± 4.275, external reward 8.278 ± 2.923, response efficacy 15.078 ± 3.889, self-efficacy 18.952 ± 4.800, cost of response 14.540 ± 5.227, and decision conflict questionnaire score 70.96 ± 11.78. ConclusionsThe study revealed that GDM patients exhibited a moderate level of decision-making dilemma. Notably, the patients' perceived susceptibility and severity of the disease, along with their response efficacy and self-efficacy, positively influenced their dietary decision-making abilities. Specifically, enhancing patients' awareness of their condition and boosting their self-efficacy significantly improved their decision-making capabilities. Conversely, internal and external rewards, as well as the cost of response, exerted a negative impact on GDM patients' decision-making abilities. Therefore, it is imperative to mitigate potential barriers in GDM patients' dietary intake behaviors, thereby enhancing their decision-making skills related to dietary intake.

Proportion of Emergency Cesarean Section in Maternity Hospitals in Kirkuk Governorate, in 2022–2023

Abstract Background: Emergency cesarean sections are undertaken before or during labor when there is an immediate concern for the mother or the fetus. Inadequate maternal management and unreliable referral systems are responsible for the massive incidence of emergency cesarean section. Objectives: This study aims to identify the rate of emergency cesarean section in Kirkuk governorate. Subjects and Methods: A cross-sectional study was conducted at the postoperative Obstetrical and Gynecological wards in Azadi Teaching Hospital and Kirkuk General Hospital, Kirkuk, Iraq, from December 1st, 2022, to February 28th, 2023. Four hundred women, who have had cesarean sections, were directly interviewed using a structured questionnaire. Official approval was obtained. Categorical data were analyzed using the Chi-square or Fisher’s exact tests P &lt; 0.05 was considered statistically significant. Results: One hundred and ninety-nine (49.8%) mothers were within 26–35 years of age. One hundred and forty-three (35.8%) had an emergency cesarean section, whereas 257 (64.3%) had an elective cesarean section. Emergency indications included failure to progress 45 (31.5%), cephalopelvic disproportion (CPD) 36 (25.2%), fetal distress 32 (22.4%), and severe preeclampsia 22 (15.4%). Poor pregnancy outcomes included bad obstetrical history 49 (12.3%), macrosomia 7 (1.8%), premature rupture of membrane 4 (1.0%), and postterm 21 (5.3%). Elective cesarean sections were significantly higher in husbands &gt;35 years, with husbands’ education (primary school), parity of 2–4, and with no pregnancy-induced hypertension (P = 0.035, P = 0.034, P &lt; 0.001, and P &lt; 0.001), respectively. Emergency cesarean sections (CSs) were significantly higher among diabetic mothers; P = 0.022. Conclusions: One-third of all CSs in Kirkuk were done as emergency operations with failure to progress, CPD, and fetal distress as the main indications.

Successfully managed multiple deformities in a non descript buffalo calf by caesarian operation

A eight-year-old non-descript buffalo was reported at Veterinary Clinical Complex, Obstetrical ward, NVC, Nagpur, Maharashtra with the complaint of failure to deliver failure of parturition. The case was diagnosed as presence of fetal monster with multiple malformations. The monster was removed successfully by caesarian operation.

Comparative performance of contact plate metod and swab method for surface microbial contamination on medical fabrics

BackgroundThe contact plate method is widely accepted and used in various fields where hygiene and contamination levels are crucial. Evidence regarding the applicability of the contact plate method for sampling fabric microbial contamination levels in real medical environments was limited. This study aimed to assess the applicability of the contact plate method for detecting microbial contamination on medical fabrics in a real healthcare environment, thereby providing a benchmark for fabric microbial sampling methods.MethodsIn a level three obstetrics ward of a hospital, twenty-four privacy curtains adjacent to patient beds were selected for this study. The contact plate and swab method were used to collect microbial samples from the privacy curtains on the 1st, 7th, 14th, and 28th days after they were hung. The total colony count on each privacy curtain surface was calculated, and microbial identification was performed.ResultsAfter excluding the effects of time, room type, and curtain location on the detected microbial load, the linear mixed-effects model analysis showed that contact plate method yielded lower colony counts compared to swab method (P < 0.001). However, the contact plate method isolated more microbial species than swab method (P < 0.001). 291 pathogenic strains were isolated using the contact plate method and 133 pathogenic strains were isolated via the swab method. There was no difference between the two sampling methods in the detection of gram-negative bacteria (P = 0.089). Furthermore, the microbial load on curtains in double-occupancy rooms was lower than those in triple-occupancy rooms (P = 0.021), and the microbial load on curtains near windows was lower than that near doors (P = 0.004).ConclusionContact plate method is superior to swab method in strain isolation. Swab method is more suitable for evaluating the bacterial contamination of fabrics.

Exploring disaster preparedness in an obstetric unit in a district hospital in the Western Cape Province

BackgroundResearch on disaster preparedness in public hospitals is limited, and specialised units such as obstetric departments need to be even more prepared when rendering health care to vulnerable populations. Disasters can be natural, such as floods due to human interventions, sinkholes due to mining, or pandemic occurrences, such as the recent COVID-19 pandemic. Research on disaster preparedness is limited, and even more so in specialised units such as obstetrics and evacuating a ward of maternal and neonatal patients present unique challenges. Being prepared for any disaster is the only assurance of effective patient healthcare during a disaster. This study explored and described nurses’ knowledge and attitudes regarding preparedness for a disaster in an obstetric unit in a public institution. The study aimed to make recommendations to improve disaster preparedness in an obstetric ward based on the nurses’ knowledge and attitudes.MethodsThis study utilised an exploratory, descriptive qualitative design within a contextual approach. The data were acquired through individual interviews that were done using a semi-structured interview schedule. An observational walkabout was performed with the unit manager to validate interviewee responses. The study employed purposive sampling with a sample size of 17 nurses (N = 32, n = 17) and a response rate of 53%. The interviews were transcribed verbatim, and later, the data underwent analysis using theme analysis and a co-coder.ResultsThe results indicate that the participants demonstrate an awareness of disaster terminology but need more assertiveness in executing the institutional disaster policy. The results illustrate that more frequent training, disaster rehearsals, and simulations should be implemented to improve disaster readiness. Strategies are recommended to enhance preparedness for a disaster in the obstetric unit.ConclusionThe study findings recommend more education and training opportunities that should be regularly instilled as a practice within the obstetric ward. More disaster drills and simulation exercises should be performed to ensure confidence in disaster preparedness. Obstetric staff of all levels should be involved with policymaking and disaster plan development.

Midwife-led obstetric triage to increase providers’ knowledge and improve timeliness of care: A pre and posttest design

BackgroundResearch in low- and middle-income countries has shown that maternal mortality is directly related to inadequate or absent obstetric (OB) triage systems. Standard triage systems and knowledge on triaging for obstetric emergencies are often absent or lacking in most healthcare systems in Liberia. ObjectiveThe objective of this research was to address the third delay defined as receiving adequate, quality care when a facility is reached by increasing knowledge through the establishment of a midwife-led, hospital-based OB triage system to stratify care based on risk and imminence of birth and to improve timely assessment at two district referral hospitals. MethodsA quasi-experimental study design using a pre/post survey was employed for a midwife-led OB triage training course. Using a train-the-trainer model, five midwives were trained as champions, who in turn trained an additional 62 providers. Test results were analyzed with the R statistical software using paired sample t-test and descriptive statistics. ResultsPretest results revealed a knowledge and practice gap among OB providers on key components of the standard triage package. However, post-test mean scores were significantly higher (M = 79.6, SD = 2.32) than pre-test mean scores (M = 59.0, SD = 2.30) for participants following a 2-day training (p = <0.001). DiscussionFollowing a structured OB triage training, participants showed significant improvement in post-test OB triage scores. ConclusionStandard OB triage protocols incorporated into the policies and procedures of obstetric wards have the potential to improve knowledge and practice, addressing the third delay and reducing preventable, obstetrics-related deaths.

A Study to Assess the Effectiveness of Planned Teaching Programme on Baby Friendly Hospital Initiative Policy among the Staff Nurses in Paediatric and Obstetric Ward in Selected Hospital of Jabalpur City

The research approach adopted for this study was experimental in nature .A pre- experimental one group pre-test post-test design was used to evaluate the effectiveness planned teaching programme on the baby friendly hospital initiative policy among the staff nurses in paediatric and obstetric ward selected hospital of Jabalpur City .The data were collected from Jabalpur Hospital &amp;Research, Napier Town Jabalpur, (M.P),Omega Children Hospital and Critical Care ,Anant hospital City Hospital, Jabalpur Using purposive sampling technique.

The Ottawa resident observation form for nurses (O-RON): evaluation of an assessment tool’s psychometric properties in different specialties

BackgroundWorkplace-based assessment (WBA) used in post-graduate medical education relies on physician supervisors’ feedback. However, in a training environment where supervisors are unavailable to assess certain aspects of a resident’s performance, nurses are well-positioned to do so. The Ottawa Resident Observation Form for Nurses (O-RON) was developed to capture nurses’ assessment of trainee performance and results have demonstrated strong evidence for validity in Orthopedic Surgery. However, different clinical settings may impact a tool’s performance. This project studied the use of the O-RON in three different specialties at the University of Ottawa.MethodsO-RON forms were distributed on Internal Medicine, General Surgery, and Obstetrical wards at the University of Ottawa over nine months. Validity evidence related to quantitative data was collected. Exit interviews with nurse managers were performed and content was thematically analyzed.Results179 O-RONs were completed on 30 residents. With four forms per resident, the ORON’s reliability was 0.82. Global judgement response and frequency of concerns was correlated (r = 0.627, P < 0.001).ConclusionsConsistent with the original study, the findings demonstrated strong evidence for validity. However, the number of forms collected was less than expected. Exit interviews identified factors impacting form completion, which included clinical workloads and interprofessional dynamics.

Association between maternal dissatisfaction with oneself at birth and shaking and smothering toward the offspring up to 18 months old

BackgroundA mother who feels dissatisfaction with herself may resort to abusive behavior such as shaking or smothering toward their offspring. Understanding this association can inform effective prevention strategies. ObjectiveThis study aimed to investigate the associations between maternal feelings of dissatisfaction with oneself and infant physical abuse. Participants and settingThe study included 434 mothers who had recently given birth in two obstetric wards in a relatively wealthy area in Tokyo, Japan. MethodsAdopting a longitudinal design, the study used questionnaires post-childbirth to measure mothers' dissatisfaction with themselves. This involved evaluating perceptions of failing to meet personal standards or self-image. Physical abuse (specifically shaking or smothering) in infants was tracked at 3, 6, 12, and 18 months. Data analysis comprised multilevel analysis, group-based trajectory modeling, and multivariable logistic regression to explore the association between maternal dissatisfaction and child physical abuse. ResultsMultilevel analysis showed that mothers with middle or high dissatisfaction with themselves were more likely to abuse their infant compared to mothers with low dissatisfaction with themselves (adjusted odds ratios [aOR] 5.71, 95 % confidence interval [CI], 1.06–30.78 and aOR 12.47, 95 % CI: 2.11–73.69, respectively). Trajectory analyses indicated that mothers with middle or high dissatisfaction with themselves were consistently more likely to abuse their infants up to 18 months (aOR 8.08, 95 % CI 1.61–40.53 and aOR 6.42, 95 % CI 1.27–32.43, respectively). ConclusionsOur findings highlight a robust association between mother's dissatisfaction with themselves and a higher risk of infant physical abuse. These insights call for a comprehensive review of preventive measures for childhood physical abuse.

A study to assess the effectiveness of planned teaching regarding the harmful effect of oil application on anterior fontanels of newborn among post-natal mothers

The anterior fontanelle, sometimes known as the “soft spot,” is an important anatomical component in neonates that allows brain growth and development. Possible harm is caused by such practices, as they may result in unfavorable outcomes, such as skin irritation and a delay in fontanelle closure. The goal of this study was to see how effective pre-planned education was at informing postpartum women about the dangers of applying oil to newborns’ anterior fontanelles. The study was conducted with the goal of increasing the understanding of the adverse effects of oil application on the anterior fontanels of newborns among postnatal mothers, The study will be thoroughly described to the participants, and their written Consent will be taken for the participate in the study and publishing the information. Sampling technique will be convenient. Population and sampling techniques will be examined. Mothers will be the target group with a sample size of 60 postnatal mothers. The sample will be drawn using The Purposive sampling approach. Prior authorization will be acquired from the designated hospitals’ higher authority. The inclusion criteria will be used to select samples. Information will be gathered from the hospital’s obstetric ward. First, pretest knowledge of the adverse effects of applying oil to newborns’ anterior fontanels among postnatal mothers was assessed. Postnatal mothers will be taught about the detrimental effects of placing oil on the anterior fontanels of their newborns. The post-test assessment of knowledge regarding the adverse effects of applying oil to anterior fontanels was performed after 7 days. If the hypothesis of our study is helpful in improving mothers’ knowledge in the post-test rather than pre-test following the intended training.