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LiteratureEvaluationTableMISLIE.docx

Literature Evaluation Table

Student Name: Mislie Jean Pierre

Summary of Clinical Issue

One of the key and major challenges seen faced by newborns is that related to the maintenance of both a neutral and thermal environment in which it seen to be critical for the reduction of both mortality and morbidity. The newborns are thus at increased risk of both hypothermia and the nurse should thus identify the associated appropriate interventions that are helpful in both maintaining the newborn health and the temperature of the associated newborn (Ramani et al., 2018). The risk of hypothermia is caused by the large surface area to body ratio, reduced subcutaneous fat and immature skin which increases evaporation of water and loss of heat. The neonates to a great extent tend to have a great water content within the body, poor metabolic function and altered blood flow to the peripheries is also a factor that induces hypothermia.

Hypothermia additionally causes a drastic increase in cellular metabolism in a particular bid to both remain and warm which is additionally associated with a very drastic and high risk of hypoxia, an increase in acidosis and that of cardiovascular complications. The phenomenon in essence increases hypoglycemia since, glucose is used to generate heat. The compensatory mechanisms for hypothermia neurological complications, hyperbilirubinemia, clotting disorders and death (Dehghani et al., 2015). Maintaining skin to skin contacts of the mother with the newborn is one of the interventions for the prevention and management of hypothermia. It is important to conduct further research to establish the effectiveness of kangaroo care in promoting temperature regulation among newborns as compared to standard procedures.

PICOT Question: Among newborns admitted in the neonatal intensive care unit (P), does kangaroo care (I) compared to conventional care (P) promote temperature regulation (O) in the first month of life (T)?

Criteria	Article 1	Article 2	Article 3
APA-Formatted Article Citation with Permalink	Dehghani, K., Movahed, Z. P., Dehghani, H., & Nasiriani, K. (2015). A randomized A randomized controlled trial of Kangaroo mother care in contrast to the conventional method on the use of vital signs and arterial oxygen saturation rates within the body of newborns who were in hospitalized or neonatal intensive care units was performed the Journal of clinical neonatology , 4(1), 26. DOI: 10.4103/2249-4847.151163	Ramani, M., Choe, E. A., Major, M., Newton, R., Mwenechanya, M., Travers, C. P. & Carlo, W. A. (2018). Kangaroo mother care is both useful and effective in the prevention of neonatal hypothermia: a randomized controlled trial within the neonates. Archives of disease in childhood, 103(5), 492-497. DOI: https://doi.org/10.1136/archdischild-2017-313744.	Çaglar, S., Gözen, D., & İnce, Z. (2014). The prevention of heat loss after birth within the preterm infants using vinyl isolation bag or the use of polyethylene wrap is thus useful. Journal of Obstetric, Gynecologic & Neonatal Nursing, 43(2), 216-223. DOI:https://doi.org/10.1111/1552-6909.12291.
How Does the Article Relate to the PICOT Question?	The article in essence informs that the provision of kangaroo care is subsequently associated with a marked improvement in aspects related to thermoregulation and subsequently aids in supporting its implementation within clinical practice in question.	The article in question is highly useful in investigating whether kangaroo mother care can be effective in both the promotion of and subsequently prevention of the same condition within neonates occurs just as the PICOT in question seeks to appropriately establish.	The study goes further to investigate vinyl isolation bags as an appropriate and alternative substitute useful for the appropriate provision of kangaroo mother care and especially for the provision of appropriate temperature regulation found within the population in question.
Quantitative, Qualitative (How do you know?)	Quantitative: the study in question involved the use of quantitative variables which in essence included activities such as temperature, the saturation of oxygen and heart rate which can be measured and analyzed effectively using statistical methods.	Quantitative: the study in question involved the measurement of temperature which in essence is considered to be a quantitative variable.	A quantitative study measuring temperature changes with use of vinyl isolation bags was subsequently used versus those of polyethylene wrap bags.
Purpose Statement	In-order to determine the subsequent impact of kangaroo mother care and to observe the vital signs of arterial oxygen saturation rate in newborns who are admitted within the neonatal intensive care units is necessary.	So as to test the hypothesis that kangaroo mother care had initiated earlier, at birth or during the first hour after birth, there is a reduction of both moderate and severe hypothermia within the bodies of term neonates especially at one hour after birth and at the time of discharge- this is when compared with standard thermoregulation of care.	In-order to properly examine the effects associated with the use fo vinyl isolation bags or polyethylene wraps- useful for the prevention of postnatal hypothermia especially within preterm infants at 32 weeks or less gestation it is crucial to perform an appropriate examination.
Research Question	The initial impact of KMC observed on within the vital signs and the arterial oxygen saturation rates within the hospitalized newborns and those within Neonatal Intensive Care Units (NICU)?	The impact of early initiation of kangaroo care on both the prevention and the associated reduction of hypothermia in neonates is thus seen?	The effects of using vinyl isolation bags or polyethylene wrap for the prevention of postnatal hypothermia within the bodies of preterm infants?
Outcome	The researchers measured effect of kangaroo care on thermoregulation, heart rate, oxygen saturation and respiratory rate.	The main outcome investigated was hypothermia reduction and prevention in children exposed to kangaroo mother care.	The outcome under investigation was temperature control and the occurrence of hypothermia.
Setting (Where did the study take place?)	Neonatal Intensive Care Unit (NICU) in Shaheed Sadoughi University of Yazd city.	Term neonates born at a tertiary delivery center in Zambia were investigated.	The neonatal intensive care unit (NICU) of the Istanbul Faculty of Medicine in Turkey.
Sample	53 neonates admitted in the NICU.	72 neonates in the neonatal intensive care unit.	59 preterm infants.
Method	This was a randomized controlled trial. 27 neonates received kangaroo care while 26 neonates received conventional incubator care.	A randomized controlled trial with 36 cases receiving kangaroo care and 36 neonates under conventional care.	22 experimental group of neonates were cared in the vinyl isolation bag while 37 received polyethylene wrap in the control group.
Key Findings of the Study	It was established that kangaroo mother care is associated with significant improvement on temperature regulation and oxygen saturation but not heart rate and respiratory rate.	Maintaining kangaroo care for 80% of the time post-delivery helps in the prevention of hypothermia.	There was reduced heat loss in the vinyl isolation bag group and reduced incidence of hypothermia as compared to the polyethylene wrap
Recommendations of the Researcher	The authors recommended kangaroo care both for improved thermoregulation and for oxygen saturation within neonates.	Kangaroo care should thus be adopted appropriately both for the prevention of hypothermia and in neonates.	Preterm infants should also be appropriately wrapped within vinyl isolation bags or should reduce the occurrence of hypothermia.

Criteria	Article 4	Article 5	Article 6
APA-Formatted Article Citation with Permalink	Shah, R. K., Sainju, N. K., & Joshi, S. K. (2018). Knowledge, attitude and practice towards kangaroo mother care. Hospital, 15(14.4), 0-098. DOI: 10.3126/jnhrc.v15i3.18855	Al-Shehri, H., & Binmanee, A. (2019). Kangaroo mother care practice, knowledge, and perception among NICU nurses in Riyadh, Saudi Arabia. International Journal of Pediatrics and Adolescent Medicine. DOI: https://doi.org/10.1016/j.ijpam.2019.11.003	Raajashri, R., Adhisivam, B., Vishnu Bhat, B., & Palanivel, C. (2018). Maternal perceptions and factors affecting Kangaroo mother care continuum at home: a descriptive study. The Journal of Maternal-Fetal & Neonatal Medicine, 31(5), 666-669. DOI: https://doi.org/10.1080/14767058.2017.1293035
How Does the Article Relate to the PICOT Question?	The knowledge, attitude and practice of kangaroo mother care is critical in promoting its adoption and reducing the risk of hypothermia in neonates.	Nurses spend most time with patients and are therefore best positioned to support kangaroo care so that its benefit of hypothermia prevention can be achieved. Understanding the knowledge and attitudes of nurses towards kangaroo care is important in identifying the facilitating and impeding factors for the practice.	Mothers are critical people in the success of kangaroo care hence evaluating their perceptions and factors affecting kangaroo care will determine its effectiveness in enhancing the neonatal outcomes. Continuation of kangaroo care at home is critical in maintaining the milestones achieved for the neonate and enhancing the wellbeing of the neonates.
Quantitative, Qualitative (How do you know?)	Qualitative: the study evaluated attitude and opinions of nurses and doctors towards kangaroo mother care.	The study was qualitative as shown by the fact that it investigated qualitative measures such as practice, knowledge and perception of nurses.	The study was qualitative since it investigated the qualitative aspect of perceptions and factors affecting kangaroo care continuum at home.
Purpose Statement	To find out knowledge, attitude and practice of kangaroo mother care among health workers.	To assess the levels of knowledge and competency of kangaroo mother care (KMC) among nurses and to identify the potential barriers to practice.	To estimate the proportion of mothers who continued to practice Kangaroo mother care (KMC) at home and evaluate potential factors influencing this practice.
Research Question	What is the knowledge, attitude and practice of kangaroo mother care among health workers in tertiary health centers?	What is the levels of knowledge and competency of kangaroo mother care (KMC) among nurses and to identify the potential barriers to practice.	What is the proportion of mothers who continued to practice Kangaroo mother care (KMC) at home and evaluate potential factors influencing this practice.
Outcome	Outcome under investigation was the practice of kangaroo mother care.	The researchers sought to determine how the knowledge and perception pf nurses towards kangaroo mother care influenced their participation in kangaroo mother care.	The outcome of the study under investigation was the success of kangaroo care based on the attitudes and perceptions of the mothers.
Setting (Where did the study take place?)	Tertiary health centers in Nepal	Neonatal intensive care units (NICUs) located in Riyadh, Saudi Arabia.	A tertiary care teaching hospital in south India
Sample	160 doctors and nurses.	209 nurses working in the neonatal intensive care unit.	200 mothers exposed to kangaroo mother care while in the hospital.
Method	A cross sectional study of healthcare workers in a tertiary hospital.	The researchers thus conducted a cross sectional study through structured and web based questionnaires.	A cross sectional descriptive study through interviews.
Key Findings of the Study	Kangaroo mother care was additionally reported to be an effective strategy for the effective promoting neonatal outcomes but the health workers reported that kangaroo care was not utilized as much as expected in their effective areas of work.	The authors established that nurses have significant knowledge on kangaroo mother care but face Significant barriers to its implementation in terms of the working environment and the mothers involved in kangaroo care. The nurses also demonstrated favorable beliefs in kangaroo care in its effectiveness to promote the neonate’s wellbeing. The authors thus established that nurses have to possess significant knowledge on the use of kangaroo mother care but are likely to face significant barriers to its implementation in terms of the working environment and the mothers who are subsequently involved in the kangaroo care. Additionally, the nurses also demonstrated favorable beliefs in the provision of kangaroo care in all of its effectiveness so as to promote the neonates’ wellbeing.	It was thus effectively established that 82.5% of the mothers continued with kangaroo care at their home- which was adequately facilitated by support from the family members and was thus hindered by the lack of privacy at home.
Recommendations of the Researcher	It was additionally it was recommended that the nurses and the doctors should appropriately aid in the guidelines for the actual and potential practice of kangaroo care.	It was additionally recommended that the nurses should be instructed to adequately provide for patients with both the appropriate and need information and to appropriately encourage them to participate in the provision of kangaroo care in-order to both improve and enhance the outcomes of the neonates.	The authors further suggested that KMC training and appropriate modules should be both embraced and used in-order to enhance the knowledge of the mothers or to improve kangaroo care and increase its adoption so that the newborn can effectively reap the associated benefits of its use. Additionally, the associated strategies to address the barriers with kangaroo care should also be effectively implemented and used.