In 2005 4 million infants died during their first 28 days of life. Despite the World Health Organization’s Millenium Development Goals to reduce that number significantly by 2010, the number had only dropped to 3.6 million in those next five years.
In an article in this month’s issue of the American Journal of Maternal and Child Nursing, School of Nursing dean Carole Kenner argues that the WHO’s goals could be met if we give more autonomy to nurses across the globe and provide an international platform for them to collaborate. “One strong voice for neonatal nursing care and education will help to improve health outcomes,” she writes, along with Marina Boykova, a doctoral student at University of Oklahoma’s College of Nursing.
The three main factors contributing to the 2010 neonatal deaths were infections, childbirth and delivery complications and preterm births, write the authors. In the US alone, preterm births grew 20% between 1990 and 2006 and is only now slowly declining. But the biggest issue governing all of this might be patient education and nurses’ education. The latter, write the authors, has been shown to be intimately linked to better patient outcomes. When nurses are educated in things like neonatal stabilization (apparently not standard for all nursing programs worldwide) and resuscitation, neonatal deaths can be reduced by 30%, and an additional 20% when community health workers receive similar training.
But nurses don’t always receive the support they need, due to things like economic status of the hospitals they work in or even just the standard protocols of various countries’ educational programs. For instance, there is simply no opportunity for increased nursing training in some regions, write the authors: “the only way is to become a physician.” Nurses have a unique opportunity to provide both care and patient education, and with adequate training that care could include procedures critical to maintaining neonatal health and survival.
Kenner was instrumental in establishing the Council of International Neonatal Nurses and this article seeks to reestablish how important that organization’s mission is. The needs are the same for neonatal nurses and care “whether in Nepal or the United States.”
By sharing information and collaborating across international boarders, which are much easier to overcome today through modern communication technologies, nurses can help improve the situation for neonatal mortality. For example, a collaboration between nurses in Oakland, California and Russia succeeded in reducing the mortality rate at St. Petersburg’s Children’s Hospital #1 from 33% to 5.7%.
“A nurse does not have to write health policy to effect change,” write the authors. “Change occurs by one nurse influencing, teaching and mentoring another one or another healthcare professional.”