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Abstract
BackgroundTanzania has approximately 40 000 newborn deaths per year, with >25% of these linked to intrapartum-related hypoxia. The Helping Babies Breathe© and Golden minute© (HBB©) programme was developed to teach skilled intervention for non-breathing neonates at birth. While Helping Babies Breathe© and Golden minute©, providing training in simulated bag and mask ventilation, is theoretically successful in the classroom, it often fails to transfer to clinical practice without further support. Furthermore, the proclivity of midwives to suction excessively as a first-line intervention is an ingrained behaviour that delays ventilation, contributing to very early neonatal deaths.MethodsThe ‘champion’ programme provided guided instruction during a real-life resuscitation. The site was Amana Hospital, Tanzania. The labour ward conducts 13 500 deliveries annually, most of which are managed by midwives. Brief mannikin simulation practice was held two to three times a week followed by bedside hands-on training (HOT) of bag and mask skills and problem solving while reinforcing the mantra of ‘air, air, air’ as the first-line intervention during a real-life emergency.ResultsChampion midwives (trainers) guided instructions given during a real emergency at the bedside caused learners beliefs to change. Trainees observed changes in baby skin colour and the onset of spontaneous breathing after effective ventilation.ConclusionsVisible success during an actual real-life emergency created confidence, mastery and collective self-efficacy.
Highlights
Tanzania has approximately 40 000 newborn deaths per year,[1] with >25% of these deaths linked to intrapartum-related hypoxia.[2]
Simulated bag and mask ventilation (BMV) skills have failed to transfer to clinical practice.[4]
The study was performed at Amana Hospital in Tanzania, with a catchment area of approximately 1 million, plus outlying hospitals that refer patients
Summary
Tanzania has approximately 40 000 newborn deaths per year,[1] with >25% of these deaths linked to intrapartum-related hypoxia.[2] The Helping Babies Breathe (HBB) programme was developed to address this problem. Simulated bag and mask ventilation (BMV) skills have failed to transfer to clinical practice.[4] the proclivity of midwives to excessively deeply suction the baby’s oropharynx is an ingrained behaviour that delays ventilation, contributing to VENDs. The problem was that despite passing traditional HBB training, the transfer of bag and mask clinical skills was not evident. The Helping Babies Breathe© and Golden minute© (HBB©) programme was developed to teach skilled intervention for non-breathing neonates at birth. The proclivity of midwives to suction excessively as a first-line intervention is an ingrained behaviour that delays ventilation, contributing to very early neonatal deaths
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