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22 cases of infant death in JDWNRH NICU in 2019

JDWNRH says deaths mainly due to complications from premature birth

The Neonatal Intensive Care Unit (NICU) unit of JDWNRH had 22 cases of infant death until 10th April this year. 18 were pre-mature births and four were term babies. Out of 22 cases of death, nine were in January, two in February, seven in March and four till 10th of April.

The cause of death as per medical superintendent of the hospital, Dr. Gosar Pemba was mostly due to the complicatiosn resulting from prematurity and risk factors associated with mothers.

He said while prematurity has a higher risk for death, the term babies also face the risk of death which is mainly caused due to lack of proper routine check-up by the mother. “As a result, the condition of baby inside the womb is not monitored and complications are not detected.”

A complaint has been lodged recently by a parent whose baby passed away earlier this month in NICU. The parents around the complainant brought to light the death of eight babies in the NICU from March 11 to April 4. The hospital has said only seven have died.

Parents alleged poor hygiene practices, not using hand sanitizers and that some trainees were not professional enough to handle such babies.

The medical superintendent said that the hospital is concerned about the death of babies in NICU and has taken necessary actions whenever required, the hospital, however, is not to be held accountable for the death.

“These babies didn’t pass away due to hospital-acquired infection but from complication resulting from prematurity and risk factors associated with mothers”. He added that with the hospital being a national referral hospital, all the serious cases are referred from across the country and the death rate in the NICU is usually between two to nine cases per month.

“In the month of March 7 babies expired in NICU and all the babies were born preterm, two were born at Phuntsholing hospital and referred to JDWNRH, four were delivered by caesarian section. One baby had a normal delivery which was also preterm”. He added all these babies are high-risk babies with maternal or neonatal complications.

Dr. Gosar said while the country sees the birth rate of around 12,000 in a year, around 40 percent of the birth happens in JDWNRH.

“When the birth number is as high as 5,000 a year, the death of two to nine in a month is a normal range since every complication is also referred here from across the country,” he said

As far as the hospital-acquired infection is concerned which led to the death of 11 babies last year, he said the hand hygiene should be practiced by all the staffs working in the NICU where the nursing management is monitoring the compliance. “Quality improvement has been initiated in NICU and nurses have been educating the parents on hand hygiene regularly and the percent compliance to hand hygiene in the NICU has improved drastically since the initiation of quality of improvement”.

No  neonatologist in NICU unit

The hospital doesn’t have a single neonatologist. Dr. Gosar said human resource capacity and lack of specialists is a challenge in the hospital. However, he said that the NICU is under the department of pediatrics and pediatricians are rotated among the pediatric ward, pediatric ICU, NICU, Phototherapy, Kangaroo mother care unit and OPD. “This is being done to ensure that all pediatricians are in touch with pediatric cases on a regular basis for one day old or more.”

“A Neonatologist used to work in NICU but now she has left the hospital as she was employed by KGUMSB and not by JDWNRH,” said Dr Gosar.

The pediatric department has six  pediatricians in the department. He said it is not necessary to have designated doctors in NICU since all 6six doctors are pediatricians and not neonatologist. “If we have neonatologist then that doctor will be designated to NICU”.

“All the specialists in the hospital carry out duty on rotational basis in the wards and this will not affect the treatment of disease”. He said the pediatricians are trained to manage newborn babies during their masters in the pediatric course which is four  years long.

Regarding the status of patients, he said there is  ample time to ask doctors when they are doing rounds and when doctors are doing follow-ups on patients. “The resident doctors are providing 24/7 service to the patients and this has greatly improved the service delivery in the hospital”.

“JDWNRH is a teaching hospital and resident doctors work under the guidance of the senior specialists,” said Dr Gosar.

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