According to Kardefelt-Winther (2014), a research critique is a systematic way of reviewing a piece of scientific research. Systematic review is done in order to highlight the strengths and weakness of the study design and the applicability of the research into practice. The following assignment aims to undertaken research critique of the paper named “A pilot study to assess the current practices of immediate newborn care for term newborns in relation to early skin-to-skin contact and delayed cord clamping among health personnel of Labour Room” published by Khyriem, Venkadalakshmi and Rana in Nursing and Midwifery Research in the year 2017. The assignment will initiate with background of the study followed by the critical analysis of the methods and the results of the study along with the ethical consideration.
The clinical or the research problem that was highlighted in the study of Khyriem and his fellow authors (2017) was: there are difference in the recommendation or regulations of practice in the domain of immediate newborn care. The World Health Organization (2013) highlighted all routine procedure like assessment of the mother and the new born is not mandatory to undertaken through immediate skin-to-skin contact. On the other hand, the regulation of World Health Organization (WHO) highlighted that cord clamping can be delayed but skin-to-skin contact during the initial hours of birth helps to prevent hypothermia and promotes breastfeeding. Thus, the main objective of the study was to assess the current practices associated with immediate newborn care in relation to early skin-to-skin contact and delayed cord clamping among the health care professionals in the labor room. They selected tertiary care hospital in North India as the main center for the conduction of the study. The main research question was to analyze relation between cord clamping and skin-to-skin contact. The rationale of the objective selected by the authors is assessment of the current practices by the healthcare professionals will help to ascertain the relation to early skin-to skin contact and delayed cord clamping in immediate newborn care. Knowing the relation will guide the future research prospects of standardization of practice. The purpose of the research question is related to the problem of the study as it mainly aims to establish the importance of skin-to-skin contact in the immediate newborn care.
The authors here used the observational approach in order to access the present practice in immediate newborn care. The main benefits of the observational study is provides access under real life situations and provides strong validity of immediate understanding (Holloway & Galvin, 2016). The present study took permission through Ethical clearance for the conducting the study from the Institute Ethics committee PGIMER Chandigarh. According to Holloway and Galvin (2016) taking permission from the concerned ethical committee is important in order to conduct the research in an organized manner. The authors mainly observed the delivery process undertaken by the 45 healthcare professionals of the obstetrics and gynecology department. They used questionnaire tools in order to record the demographic and experience profile of the physicians and the observational checklist of 13 full term deliveries (during the month of July) include sequence to steps undertaken after the birth of the new-born (gestational age of 37 to 42 weeks) in relation of delayed cord clamping and early skin-to-skin contact. They excluded new-born born to mother will cardiac problems, severe bleeding and eclampsia. This exclusion helps to reduce the chances of selection bias. There were no significant risks of the subjects participated in the study as the authors mainly observed the process of delivery and did not conduct any trails over them. This is also the reason that there is no definite time-period of the study. They only observed the delivery process and did not conduct any follow-up. There are no direct benefits associated with the study but the results elucidated in this study will help proper standardization of the new-born care protocols and will also help to access the level of knowledge and nature of practice followed by the healthcare professionals. The dependent variable of the research that remained constant through the progress of the research is immediate newborn care and the independent variable is the time-span and the degree or preference of early skin-to-skin contact and delayed cord clamping (this is not constant as there is change in preference between the two process). The rigor of this quantitative study is statistical analysis of the collected data based on mean standard deviation (SD). The use of mean SD used to provide detailed quantitative perspective of data to extract the average outcome.
The analysis of the results highlighted that warm and dry linens were kept ready at the time of birth and the mother was provided with clear gowns during all the 13 deliveries. Breastfeeding was started with one hour of the birth of birth in 92.31% of cases and delayed cord clamping was used in 30.76% of the cases while early skin-to-skin contact was not executed with any of the deliveries. The main limitation of the study is its poor sample size. The ratio of the healthcare professionals demographic signifies only 4 males and 41 females. This disparity in the ration of male, female, and poor sample size might lead to biased outcome (Kaufman, 2017). The implications of the study are, it highlighted that there is lack of adequate practice of the process of delayed cord clamping and early skin-to skin contact. The study highlighted an immediate need to proper newborn practices in relation to early skin-to-skin contact and delayed cord clamping via designing proper protocol and educating healthcare professionals to bring further improvement in the newborn care. The future implication of the study must be designed in such a way that it increases the importance of skin-to-skin contact under nursing care. According to Koller Kologeski et al. (2017) increase in the skin-to-skin contact in nursing care helps to promote mother and child bonding and promotes humanized care approach. In relation to skin-to-skin contact, Nahidi et al. (2014) conducted a questionnaire based development and psychometric evaluation. The results highlighted that numerous and irrelevant responsibilities which are imparted on the midwives has caused decreased in the interest in undertaking the care of newborn of the through skin-to-skin contact. Thus, in future care planning o new norms, the responsibilities of the nursing professionals must be devised in a strict manner so that they might provide adequate time in delivering skin-to-skin contact.
Before initiating the study, the authors took permission from Institute Ethics committee PGIMER Chandigarh. The mane of the healthcare professionals who conducted the delivery in the Labor room and the name of the mothers over whom the observational study were conducted were not disclosed as per the data protection act. The revealed data only included the demographics of the selected group of the healthcare professionals.
Conclusion
The analysis of the article highlighted that the healthcare professionals who are providing care in the Labor room displayed inadequate practice in delayed cord clamping and early skin-to-skin contact. Thus main thesis statement, which evolved from the study, is proper standardization protocol are required to be undertaken in order to educate the healthcare professionals and subsequently bring change in the newborn practice protocol. Moreover, the analysis of the additional articles in relation to the newborn care highlighted that effective importance must be given to the skin-to-skin contact between the mother and the newborn. Emphasis over the skin-to-skin contact helps in developing proper bonding among the mother and child and helps to increase an humanized approach in the care plan.
References
Holloway, I., & Galvin, K. (2016). Qualitative research in nursing and healthcare. John Wiley & Sons.
Kardefelt-Winther, D. (2014). A conceptual and methodological critique of internet addiction research: Towards a model of compensatory internet use. Computers in Human Behavior, 31, 351-354. https://doi.org/10.1016/j.chb.2013.10.059
Kaufman, J. S. (2017). Methods in social epidemiology (Vol. 16). John Wiley & Sons.
Khyriem, B., Venkadalakshmi, V., & Rana., A. (2017). A pilot study to assess the current practices of immediate newborn care for term newborns in relation to early skin-to-skin contact and delayed cord clamping among health personnel of Labour Room. Nursing and Midwifery Research Journal. 13(3). 2017.
Koller Kologeski, T., Strapasson, M. R., Schneider, V., & Renosto, J. M. (2017). Skin To Skin Contact Of The Newborn With Its Mother In The Perspective Of The Multiprofessional Team. Journal of Nursing UFPE/Revista de Enfermagem UFPE, 11(1). Retrieved from: https://web.a.ebscohost.com/abstract?direct=true&profile=ehost&scope=site&authtype=crawler&jrnl=19818963&asa=Y&AN=120615045&h=yVucDU6diI%2bdQ0NiNwTplFXb82s5UBlC44kAKB8qEhyMwbK0U6VfuAhMMRMvc5pxF%2bdTar49sxpHYuVZOI6%2b3w%3d%3d&crl=c&resultNs=AdminWebAuth&resultLocal=ErrCrlNotAuth&crlhashurl=login.aspx%3fdirect%3dtrue%26profile%3dehost%26scope%3dsite%26authtype%3dcrawler%26jrnl%3d19818963%26asa%3dY%26AN%3d120615045
Nahidi, F., Tavafian, S. S., Heidarzadeh, M., Hajizadeh, E., & Montazeri, A. (2014). The Mother-Newborn Skin-to-Skin Contact Questionnaire (MSSCQ): development and psychometric evaluation among Iranian midwives. BMC pregnancy and childbirth, 14(1), 85. https://www.biomedcentral.com/1471-2393/14/85
World Health Organisation. (2013). Maternal, newborn, child and adolescent health. Access date: 28th September 2017. Retrieved from: https://www.who.int/maternal_child_adolescent/en/
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