American Journal of Nursing Research
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American Journal of Nursing Research. 2020, 8(2), 132-141
DOI: 10.12691/ajnr-8-2-1
Open AccessArticle

Impact of Puerperal Sepsis Self-Care Nursing Guideline on Women's Knowledge and Practices

Wafaa Mostafa Ahmed Gamel1, Amal Sarhan Eldesokey Genedy1 and Hanan Elzeblawy Hassan2,

1Maternal and Neonatal Health Nursing Department, Faculty of Nursing, Fayoum University, Egypt

2Maternal and Newborn Health Nursing Department, Faculty of Nursing, Beni-Suef University, Egypt

Pub. Date: January 10, 2020

Cite this paper:
Wafaa Mostafa Ahmed Gamel, Amal Sarhan Eldesokey Genedy and Hanan Elzeblawy Hassan. Impact of Puerperal Sepsis Self-Care Nursing Guideline on Women's Knowledge and Practices. American Journal of Nursing Research. 2020; 8(2):132-141. doi: 10.12691/ajnr-8-2-1


Background: Over 30.000 maternal deaths were referred to as postpartum sepsis; which consider as the third most frequent cause of approximately 290.000 maternal deaths worldwide. Puerperal sepsis is an important public health problem which is а leading cause of maternal death, especially, in developing countries due to the lack of knowledge on preventive methods. This study aimed to investigate the impact of puerperal sepsis self-care nursing guidelines on women's knowledge and practice among primiparous postnatal mothers. Subjects and Methods: An interventional quasi-experimental, pre-posttest, research design was carried out at the postpartum unit of Fayoum General and University Hospitals on 100 primiparous women. Data were collected using а structured interview questionnaire. Results: There is а highly significant improvement of the studied women’s knowledge regarding puerperal sepsis after introducing of the puerperal sepsis self-care-nursing-guidelines compared with pre-intervention (p<0.001). There are no significant differences in the total score of knowledge about socio-demographic variables (p>0.05). However, improvement of women’s knowledge regardless of their demographic variables was noticed in both immediately-intervention and one-month after the intervention. Conclusion: The primiparous-postnatal mothers who received and compliance with the guidelines regarding puerperal sepsis and its prevention had high knowledge and practices score in the post-test of the intervention program than in pre-test (P≤0.01), which shows the effectiveness of puerperal sepsis self-care nursing guidelines in increasing the knowledge score of primiparous post-natal mothers regarding the prevention of puerperal sepsis. Recommendations: Such guideline needs to be given while the antenatal period also and thus promote healthy post-partum period. The study can be replicated in а larger sample, in different settings.

puerperаl sepsis self-cаre nursing guidelines knowledge and prаctices

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[1]  Dutta D., (2004). Text Book of Obstetrics Including Perinatology & Contraception, 6th ed., Central book publisher, Calcutta 102-103.
[2]  Bamfo JEAK. (2013). Managing the risks of sepsis in pregnancy. Best Pract Res Clin Obstet Gynaecol.; 27(4): 583-95.
[3]  Maharaj D., (2007). Puerperal pyrexia: a review. Part I. Obstet Gynecol Surv.; 62(6): 393-399.
[4]  Acosta CD., and et. al., (2014). Severe maternal sepsis in the UK, a national case control study. PLoS Med. 2014; 11(7).
[5]  WHO. Trends in Maternal Mortality: 1990 To 2013. Estimates by WHO, UNICEF, UNFBA, the World Bank and the United Nations Population Division. Geneva: World Health Organization; 2014.
[6]  Kassebaum Nj, et al., (2014). Global, Regional, and National Levels and Causes of Maternal Mortality during 1990-2013: A Systematic Analysis for the Global Burden Of Disease Study 2013. Lancet. 2014.
[7]  Arulkumaran N. & Singer M., (2013), Puerperal sepsis. Best Pract Res Clin Obstet Gynaecol. 2013 Dec; 27(6):893-902.
[8]  Hussein J, et. al., (2011). A review of health system infection control measures in developing countries: what can be learned to reduce maternal mortality. Global Health. 2011; 7:14.
[9]  Tabatabaei S., Behmanesh Pour F. and Azadeh H., (2016). Infection Control Practices and Program Management in Labor and Delivery Units: A Cross-Sectional Study From Iran, Int J Infect. 2016 April; 3(2).
[10]  Wildman K., et al., (2003). European indicators of health care during pregnancy, delivery and the postpartum period, Elsevier, European Journal of Obstetrics & Gynecology and Reproductive Biology 111 (2003) S53-S65 S59.
[11]  Farg D. and Hassan H. (2020). Obstetric Outcomes for Teenage and Adult Pregnancy: A Comparative Study; 7(1): of Nursing & Care Open Access Journal: 1-16.
[12]  Nady F., El-Sherbiny M., Youness E., Hassan H. (2018). Effectiveness of Quality of Life Planned Teaching Program on Women Undergoing Gynecologic Cancer Treatment. American Research Journal of Oncology; 1(1): 1-17.
[13]  Nasr E, Hassan H. (2016). Association between quality of family planning services and client’s satisfaction level in maternal and child health centers in Port Said city. Journal of Nursing Education and Practice; 6(1): 85-99.
[14]  White L., Duncan G., Baumle W., (2011). Foundations of Maternal & Pediatric Nursing, 3rd ed., Cengage Learning, United States of America, Pp. 107-130.
[15]  Jayanthi G., (2009). A Study To Assess The Knowledge And Attitude On Prevention Of Puerperal Infection Among Staff Nurses At Selected Hospital Bangalore.
[16]  Hassan, H., Zahran, K., Youness, E., & Nady, F. (2015). Pregnant Women's Awareness, Intention and Compliance regarding Folic Acid Usage for Prevention of Neural Tube Defects According to Health Belief Model in Beni-Suef City. Pyrex Journal of Nursing and Midwifery, 1(3), 13-26.
[17]  Hassan, H., Nady, F., Youns, E., & Zahran, K. (2016). Call for Change Level of Knowledge, Awareness and Attitude to Follow A High Folate Diet Among Pregnant Women. IOSR Journal of Nursing and Health Science, 5(1), 93-100.
[18]  Said, A. (2016). Effect of counseling intervention on women's knowledge, practices and lifestyle of fetal well-being among Primigravida. International Journal of Nursing Science, 6(4), 87-93
[19]  Farg, D., & Hassan, H. (2019). Study Hyperemesis Graviderum Requiring Hospital Admission during Pregnancy: Effect of Nursing Implication on Its Progress. American Journal of Nursing Research, 7(3), 328-341.
[20]  Hassan, H., Said, S., & Hassanine, Sh. (2017). Disparities of Prevalence and Causes of Maternal Antenatal Anxiety among Primigravida Pregnant Women in Egypt. American Research Journal of Nursing, 3(1), 1-15.
[21]  Mostafa H., Yousef F., Hassan H. (2018). Health Related Quality of Life Educational Interventions: Effect on Chronic Hepatitis C Patients'. Saudi Journal of Nursing and Health Care; 1(2): 56-67.
[22]  Said S., H., A. . American Journal of Nursing Research. 2018; 6(2): 59-66.
[23]  Atwa A., Hassan H., Ahmed S. (2019). The impact of a hospital-based awareness program on the knowledge of patients about breast cancer and cancer cervix. International Journal of Studies in Nursing; 4(1): 20-29.
[24]  Duarte M., et al., (2014). Nursing Practice on Puerperal Infection Control: Integrative Review. J Nurs UFPE on line, Recife, 8(2):433-41, Feb., 2014.
[25]  Almeida MS., Silva IA., (2013). Women’s needs in immediate puerperium in a public maternity in salvador, Bahia, Brazil. Rev. Esc. Enferm USP. 2013; 42(2): 347-54.
[26]  Busanello J., & et al., (2013). Woman's participation in the decision process of the pregnancy and puerperal cycle: nursing care integrative review. 2013; 32(4): 807-14
[27]  Hassan H. (2016). Infertility profile, psychological ramifications and reproductive tract infection among infertile women, in northern Upper Egypt. Journal of Nursing Education and Practice; 6(4): 92-108.
[28]  Fraser D., & Cooper M., (2003). Myles: Textbook for Midwives, 14th ed., Churchill Livingstone, London: 643-49.
[29]  Gamel W., Hassan H., El-ezazy A. Male Infertility and Psychological Repercussions: Α Neglected Problem in Northern Upper Egypt. International Journal of Studies in Nursing, 2019; 4(4): 1-26.
[30]  Lalitha H., (2016). A study to assess the knowledge and practice of postnatal mothers on prevention of selected puerperal infections in a selected maternity hospital .medical science journal. 2016; 2 (2) 01-03
[31]  Belagavi P., Hetal S., Payal B., et al. (2015). Knowledge regarding puerperal sepsis and its prevention among postnatal mothers in selected hospitals of Bhavnagar. Journal of International Academic Research For Multidisciplinary; 3:(4), 29-34.
[32]  Taskin T, & et al., (2016). Socio-demographic factors and puerperal Sepsis: experiences from two tertiary level hospitals in Bangladesh. Int J Community Fam Med. 2016; 1(113): 1-4.
[33]  Demisse G., & et al, (2019). Determinants of puerperal sepsis among postpartum women at public hospitals in west SHOA zone Oromia regional STATE, Ethiopia (institution BASEDCASE control study), BMC Pregnancy and Childbirthvolume 19, Article number: 95 (2019), available at:
[34]  Masoud et al (2016). Effectiveness of puerperal sepsis self-care guideline on women health during puerperium.
[35]  Mathew R., (2013). A Study to Assess The Effectiveness of Structured Teaching Programme on Prevention of Puerperal Infections among Primi Postnatal Mothers in Selected Hospitals at Mangalore, Rajiv Gandhi University of Health Sciences, Karnataka, available at:
[36]  Singh, A., Agarwal, V. K., Chaudhary, V., Singh, A. & Sharma, M. (2011). Perception of RTIS/STDs among women of reproductive Age Group in a district of Utter Padesh, National Journal of Integrated Research in Medicine; 2(1), 25-28.
[37]  Yahaya SJ1, . (2013). Knowledge of symptoms and signs of puerperal sepsis in a community in north-eastern Nigeria: a cross-sectional study. ; 33(2):152-4
[38]  Indra V., (2015). A Study to Assess the Knowledge and Practice on Prevention of Puerperal Sepsis among Postnatal Mothers in Selected Hospital, Puducherry with a View to Develop an Information Booklet, Int. J. Nur. Edu. and Research 3(4). Oct.-Dec., 2015; Page 410-418.
[39]  Larson E., Quiros D. & Lin S., (2007). Dissemination of CDC, S Hand Hygiene Guideline and impact on infection rates. Am J Infect Control. 2007; 35(10): 666-675.
[40]  Hassan H. (2018). Effectiveness of a structured teaching program on anxiety and perception regarding toxoplasmosis among seropositive pregnant women in Northern Upper Egypt. Clinical Nursing Studies; 6(1): 1-19.
[41]  Hassanine Sh., Hassan H., Alkotb Z. (2017). Effect of Preventive Program on Progression of Osteoporosis among Female Patients over 40 years at El-Fayoum City. American Research Journal of Nursing; 3(1): 1-15.
[42]  Hassan H. (2019). . International Journal of Health and Biological Sciences; 2(1): 17-18.
[43]  Masters K. (2013). Edgar Dale’s Pyramid of Learning in medical education: A literature review, Medical Teacher; 35(11): e1584-e1593.
[44]  Hassan H., Mohamady Sh., & Abd El-Gawad N. (2017). Protocol for improving nursing performance towards placental examination at labor units. Clinical Nursing Studies; 5(2): 1-11.
[45]  Hassan H, Nasr E. (2017). Improving nurses’ knowledge and skills regarding tocolytics for inhibiting preterm labor. Clinical Nursing Studies; 5(1): 1-12.
[46]  Nady F., Said M., Youness E., Hassan H. (2017). Impact of Tailored Educational Program of Quality of Life Improvement on Women Undergoing Breast Cancer Treatment at El-Minia Region, Egypt. American Research Journal of Gynaecology; 1(1): 1-17.