Nursing care for children with trachea-esophageal fistula in a tertiary children hospital of Nepal-10 years experience
Dinesh Prasad Koirala, BM Basnet and MS Pun
Kanti Children Hospital, Nepal
: J Womens Health, Issues Care
Abstract
Today developing country like Nepal is facing challenges for neonatal nursing care. Absence of well-defined protocol and policies has added more difficulties on this. Even the challenges become more as the nursing practices for pediatric surgery is vague and is quite unknown to us. This study enlightens the nursing care that exists in only one children hospital of Nepal. Our nursing protocol includes preparation of receiving child in Emergency, transferring to NSICU, preparation in NISCU, pre-operative oral or upper pouch suctioning, assessment of respiratory status and oxygen therapy. Our protocol also includes our experience at fluid and electrolytes maintenance, measurement of temperature, care of neonate at operation theatre. We shall share our experience in nursing care after primary repair or stage procedure i.e. positioning, restrains hand, securing transanastomotic nasogastric tube, assessment and management of pain, chest physiotherapy. We have protocols for nursing oesophagostomy and gastrostomy and care for intubated neonates, discharge advice given to attendants. We had more than 300 cases in last 10 years with survival rate of 65.5%. The practices have been feasible and acceptable for utilization in practices. However a valid, internally consistent nursing care protocol and observation checklist is yet to be developed.
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