B.) During Postpartum.
In the study, it was discovered that only 64.9% of the women
had their vital signs checked after delivery. A great proportion of 45.1% never
had their vitals checked. Only 33.6% of the study population had their vital
signs checked regularly or 30 minutes after delivery. This is poor nursing
practice as the first four hours after delivery is a critical period and vital
signs are an important indicator of adverse changes [25].
From this survey it was observed that postpartum teachings
were very poor as more than half of the patients were not taught anything. Only
24.3% had teachings on how to care for their perineum, 16.2% were taught how to
breastfeed their babies, 8.1% were taught how to care for the umbilical cord,
13.5% of the population were taught how to bath their babies, 29.7% were taught
on good feeding habits and only 13.5% were taught on hygiene. All these show
the lack of zeal in postpartum follow-up and care.
After delivery, both the mother and the baby will have health
concerns that need to be addressed attentively [31] but from the analysis of
the data collected, 73% of the babies were not examined. Of the 27% who said
their babies were examined, 60% had their babies examined just once a day. Thus
the babies were not being given full attention.
Concerning postpartum checks done on the mothers, 48.6% were
checked for bleeding and this proportion is quite small considering the
complications of postpartum haemorrhage. A small proportion 29.7% had their
breasts examined. This proportion is too small as women who could have breast
engorgement or breast infections will not be easily identified and possibly
screened for breast cancer [31]. Only 13.5% had their genitals examined.
Genital examinations are very important in evaluating postpartal adaptation
[23]. Blood loss during the birth process is common and so checking the
conjunctivae will be indicative if the woman is anaemic. Paradoxically only
45.9% had their conjunctivae checked. 29.7% of the women were checked for
uterine involution which was not enough.
From the above analyses it can be concluded that the mothers and
their babies are not well followed up after delivery rendering postpartum
nursing care poor.
5.1.4. Patients' Satisfaction with Nursing
Care
A.) During Intrapartum.
Five indicators were used to determine patients satisfaction
with nursing care: Nurses' ability to inform patients, Nursing concern and
care, Nursing skill and competence, A restful atmosphere provided by the nurse
and the coordination of care.
In this study, the majority (35.3%) rated the nurses ability
to pass on information as good, 20.6% as fair ,24.9% as poor and 14.7 % as very
good. This implies that the majority were fairly satisfied with the information
they received. This is a true picture because if we relate it to the
information they were given during this period, most of them (60.6%) were
taught breathing techniques as seen on Table 11 and many of them
(40.6%) did not have explanations of what they were going through as shown on
Table 14. From the suggestions the patients gave, the attitude of the
nurse or mode of passing on the information too could be a factor which will
rate the information as being fairly satisfactory.
For Nursing care and concern, an equal majority 35.1% rated it
good and fair (fairly satisfied and fairly unsatisfied) while 10.8% were
unsatisfied. Summarily, more people (54%) were fairly satisfied .This could be
explained by the fact that many women (63.9%) were given comfort measures
during the pain and difficulty they went through. (See Table 10)
As concerns the skill and competence of the nurse, a majority
rated it good meaning that they were fairly satisfied. Also a large proportion
(24.2%) rated it very good implying that they were satisfied with the nurses'
skill. From the nursing care given, majority said the nurse was there to
administer their medications and respond to emergencies. This is in line with
most studies which indicate that the nurse focuses on tasks [33].
Most respondents rated nurses' ability to provide a restful
and quiet atmosphere as being good. This is justified by the 94.4% of the
patients who acknowledged that the labour ward was clean as shown on Table
12.
For coordination of care, most of the respondents (46.9%)
rated the teamwork spirit of the nurses as good, 25.0% as very good, 18.8% as
fair and 9.6% as poor. This brings us to the conclusion that the respondents
were fairly satisfied with the coordination of care.
A Likert's scale was drawn for the six points and the Mean
value gotten signified that the nursing care was good. This implies that the
participants were fairly satisfied with the care they received during the
intrapartum period. Hence more effort must be put in so as to fully satisfy the
patients.
| 
