Standards and Guidelines for Neonatal Care and Neonatal Nursing: An Indian Perspective

Quality assurance is that set of activities that are carried out to set standards and to monitor and improve performance so that the care provided is as effective and as safe as possible. Standards and guidelines are basis for measuring quality of care provided. The quality of neonatal care in India varies from no care to highly advanced care comparable to any centers in the world.

Existing standards for neonatal care in India include : structure standards (Indian Public Health Standards and Accreditation Guidelines for Level II and Level III Neonatal units); process standards (Integrated Management of Neonatal and Childhood Illnesses, Home Based Neonatal Care, Clinical Standards and Guidelines- policies and protocols for neonatal units) ; and Outcome Standards ( Neonatal Mortality Rate and morbidity rates, length of hospital stay, Family satisfaction, expected improvement in clinical) The problems which come in way of the delivery of quality services to the newborn include lack of uniformity in the system, poorly communicated guidelines, challenges in implementation of existing guidelines and lack of practice standards for neonatal nurses. Following strategies may help to improve the quality of health care delivery and to solve existing problems : developing and revising National guidelines, developing and revising national service delivery guidelines, endorsing guidelines to all health care sectors officially, implementing guidelines, strengthening supporting systems to ensure implementation, and implementing neonatal nursing standards.

Neonatal nursing standards are to be developed and communicated to all practicing neonatal nurses. Indian Nursing Council and Indian Association of Neonatal Nurses can join and develop practice standards for neonatal nurses. Once standards are set, uniformly implemented, and evaluated at all levels of neonatal care, the quality of care would improve drastically, thus the neonatal survival.