Abstract
BackgroundWe assessed the effect of an adapted neonatal resuscitation program (NRP) course on healthcare providers’ performances in a low-resource setting through the use of video recording.MethodsA video recorder, mounted to the radiant warmers in the delivery rooms at Beira Central Hospital, Mozambique, was used to record all resuscitations. One-hundred resuscitations (50 before and 50 after participation in an adapted NRP course) were collected and assessed based on a previously published score.ResultsAll 100 neonates received initial steps; from these, 77 and 32 needed bag-mask ventilation (BMV) and chest compressions (CC), respectively. There was a significant improvement in resuscitation scores in all levels of resuscitation from before to after the course: for “initial steps”, the score increased from 33% (IQR 28–39) to 44% (IQR 39–56), p<0.0001; for BMV, from 20% (20–40) to 40% (40–60), p = 0.001; and for CC, from 0% (0–10) to 20% (0–50), p = 0.01. Times of resuscitative interventions after the course were improved in comparison to those obtained before the course, but remained non-compliant with the recommended algorithm.ConclusionsAlthough resuscitations remained below the recommended standards in terms of quality and time of execution, clinical practice of healthcare providers improved after participation in an adapted NRP course. Video recording was well-accepted by the staff, useful for objective assessment of performance during resuscitation, and can be used as an educational tool in a low-resource setting.
Highlights
Each year about 6.6 million children worldwide under the age of 5 die and of these 44% are newborns
There was a significant improvement in resuscitation scores in all levels of resuscitation from before to after the course: for “initial steps”, the score increased from 33% (IQR 28–39) to 44% (IQR 39–56), p
Resuscitations remained below the recommended standards in terms of quality and time of execution, clinical practice of healthcare providers improved after participation
Summary
Each year about 6.6 million children worldwide under the age of 5 die and of these 44% are newborns. According to the World Health Organization, about a quarter of these newborns die in the first 24 hours. We must add the 3 million stillbirths recorded annually [1,2,3]. In 2012, the neonatal mortality rate in Mozambique was estimated at 34/1000 live births. The rate of stillbirth was 28/1000 total births. Neonatal deaths constituted 35% of an estimated 85000 deaths under five years of age [4]. We assessed the effect of an adapted neonatal resuscitation program (NRP) course on healthcare providers’ performances in a low-resource setting through the use of video recording
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