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Evaluation of an adapted model of the World Health Organization partograph used by Angolan midwives in a peripheral delivery unit

Odberg Pettersson, Karen, 1951- (author)
Högskolan i Halmstad,Sektionen för hälsa och samhälle (HOS)
Svensson, Marie-Louise (author)
Högskolan i Halmstad,Sektionen för hälsa och samhälle (HOS)
Christensson, Kyllike (author)
Karolinska Institutet
 (creator_code:org_t)
Edinburgh : Churchill Livingstone, 2000
2000
English.
In: Midwifery. - Edinburgh : Churchill Livingstone. - 0266-6138 .- 1532-3099. ; 16:2, s. 82-88
  • Journal article (peer-reviewed)
Abstract Subject headings
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  • Background: The addition of laboratory bilirubin readings to an algorithm based on pH alone improves prediction of feeding tube location; although reliable pH-teststrips are available, there is no bedside test to measure bilirubin in feeding tube aspirates.Objectives:This study was designed to test the efficacy of a bilirubin teststrip with a newly developed scale in measuring the bilirubin content in feeding tube aspirates, and to determine the effectiveness of a combination of readings from pH and bilirubin teststrips in predicting feeding tube location.Methods:A total of 631 gastrointestinal specimens for concurrent pH and bilirubin testing were obtained from adult, acutely ill patients with newly inserted feeding tubes (nasogastric, n = 328; nasointestinal, n = 303) within 5 minutes of radiographs taken to determine tube location. In addition, 225 respiratory specimens were tested. Bilirubin was measured with a teststrip incorporating a newly developed colorimetric visual bilirubin (VBIL) scale, and by a laboratory assay, pH was measured with a teststrip and a pH-meter. Results from the bilirubin and pH tests were read by research assistants and staff nurses and compared with tube location as determined by radiography.Results:The correlation between readings made from the 5-point VBIL scale and the trimmed laboratory bilirubin was 0.93, with dichotomized readings correlating 0.87 and kappa equal to 0.86. A pH greater than 5 and a bilirubin less than 5 mg/dL successfully identified 100% of the 225 respiratory cases. In the category of pH 5 or less and bilirubin less than 5 mg/dL, 98% of the cases were gastric cases. In the category of pH greater than 5 and bilirubin 5 or higher mg/dL, nearly 88% of the cases were intestinal cases.Conclusions:The newly developed VBIL scale is effective in determining the bilirubin content in feeding tube aspirates. Furthermore, compared with predicting tube location from pHpaper alone, dichotomized readings from the VBIL scale/bilirubin teststrip used in combination with a pH-teststrip improved the ability to differentiate between respiratory and gastrointestinal tube placement, as well as between gastric and intestinal tube placement. Refinement of the VBIL scale is indicated to increase its accuracy.

Subject headings

NATURVETENSKAP  -- Geovetenskap och miljövetenskap (hsv//swe)
NATURAL SCIENCES  -- Earth and Related Environmental Sciences (hsv//eng)
SAMHÄLLSVETENSKAP  -- Ekonomi och näringsliv (hsv//swe)
SOCIAL SCIENCES  -- Economics and Business (hsv//eng)

Keyword

Adolescent
Angola
Education
Nursing
Continuing
Evaluation Studies
Female
Labor
Obstetric
Medically Underserved Area
Midwifery
Pregnancy
Professional Autonomy
Staff Development
World Health Organization
MEDICINE
MEDICIN

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ref (subject category)
art (subject category)

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NATURAL SCIENCES
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Midwifery
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Halmstad University
Karolinska Institutet

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