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Implementing delayed umbilical cord clamping in Nepal - Delivery care staff's perceptions and attitudes towards changes in practice [Elektronisk resurs]

Rana, Nisha, 1979- (författare)
Brunell, Olivia (författare)
Målqvist, Mats, 1971- (författare)
Uppsala universitet Medicinska och farmaceutiska vetenskapsområdet (utgivare)
Publicerad: 2019
Engelska.
Ingår i: PLoS ONE. - 1932-6203. ; 14:6
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  • Aim: To explore delivery care staff's perceptions and attitudes towards changes in practice of umbilical cord clamping in order to identify work culture barriers and enablers for improved clinical practice and implementation of the new guidelines on cord clamping. Method: A purposive sampling strategy was used to include delivery staff at two major hospitals in Kathmandu, Nepal for focus group discussions. Key informant interviews were conducted with ward in-charge and Skilled Birth Attendant trainers at the respective hospitals. Data are analysed through qualitative content analysis. Result: Participants had positive attitudes towards delayed cord clamping as it was not perceived to be a difficult task and as they perceived it to be beneficial for mother and child. The will to do good and a high level of trust in the hierarchical system and in scientific evidence were identified as promoters of change. Several barriers were mentioned, such as maternal or foetal medical conditions and physical settings, as constrains to performing delayed cord clamping. They also mentioned difficulties in adopting new guidelines due to habitual practice, lack of formal training and poor coherence within the work team. In order to bring change to the practice participants highlighted that authorized national and institutional protocols and regular training are crucial. Conclusion: Due to poor coherence within the health system and lack of national or institutional protocols, delivery staff have to rely on their own skills development and informal decision making, and are therefore hesitant to apply new routines of delayed cord clamping. In order to change cord clamping practices to comply with evidence and policies health-care staff need to be better supported by the governance structures of the health system, with clear and approved guidelines made available and coherent training and support. 

Ämnesord

Medical and Health Sciences  (hsv)
Health Sciences  (hsv)
Public Health, Global Health, Social Medicine and Epidemiology  (hsv)
Medicin och hälsovetenskap  (hsv)
Hälsovetenskaper  (hsv)
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi  (hsv)
Hälso- och sjukvårdsforskning  (uu)
Health Care Research  (uu)

Genre

government publication  (marcgt)

Indexterm och SAB-rubrik

Implementing delayed cord clamping
Perception
attitude
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