Neonatal Resuscitation Practices Research Articles

Neonatal Resuscitation Practices in Portuguese Delivery Rooms: A Cross-Sectional Study.

Data from previous studies have demonstrated inconsistency between current evidence and delivery room resuscitation practices in developed countries. The primary aim of this study was to assess the quality of newborn healthcare and resuscitation practices in Portuguese delivery rooms, comparing current practices with the 2021 European Resuscitation Council guidelines. The secondary aim was to compare the consistency of practices between tertiary and non-tertiary centers across Portugal. An 87-question survey concerning neonatal care was sent to all physicians registered with the Portuguese Neonatal Society via email. In order to compare practices between centers, participants were divided into two groups: Group A (level III and level IIb centers) and Group B (level IIa and I centers). A descriptive analysis of variables was performed in order to compare the two groups. In total, 130 physicians responded to the survey. Group A included 91 (70%) and Group B 39 (30%) respondents. More than 80% of participants reported the presence of a healthcare professional with basic newborn resuscitation training in all deliveries, essential equipment in the delivery room, such as a resuscitator with a light and heat source, a pulse oximeter, and an O2 blender, and performing delayed cord clamping for all neonates born without complications. Less than 60% reported performing team briefing before deliveries, the presence of electrocardiogram sensors, end-tidal CO2 detector, and continuous positive airway pressure in the delivery room, and monitoring the neonate's temperature. Major differences between groups were found regarding staff attending deliveries, education, equipment, thermal control, umbilical cord management, vital signs monitoring, prophylactic surfactant administration, and the neonate's transportation out of the delivery room. Overall, adherence to neonatal resuscitation international guidelines was high among Portuguese physicians. However, differences between guidelines and current practices, as well as between centers with different levels of care, were identified. Areas for improvement include team briefing, ethics, education, available equipment in delivery rooms, temperature control, and airway management. The authors emphasize the importance of continuous education to ensure compliance with the most recent guidelines and ultimately improve neonatal health outcomes.

Assessment of pre and post Neonatal Resuscitation program (NRP) training in a neonatal intensive care unit of Pakistan

Assessment of pre and post Neonatal Resuscitation program (NRP) training in a neonatal intensive care unit of Pakistan

Neonatal Resuscitation Practices in Romania: A Survey of the Romanian Association of Neonatology (ANR) and the Union of European Neonatal and Perinatal Societies (UENPS).

This study is part of a European survey on delivery room practices endorsed by the Union of European Neonatal and Perinatal Societies (UENPS) and the Romanian Association of Neonatology (ANR). The aim of our study was to evaluate the current neonatal resuscitation practices in Romanian maternity hospitals and to compare the results between level III and level II centers. The questionnaire was distributed through ANR by email link to heads of neonatal departments of 53 Romanian maternity hospitals with more than one thousand of births per year between October 2019 and September 2020, having 2018 as the reference year for data collection. The overall response rate to the questionnaire was 62.26% (33/53), 83.33% (15/18) for level-III centers and 51.43% (18/35) for level-II centers. Of the responding centers, 18 (54,54%) were academic hospitals, 15 (83,33%) were level III and 3 (16,67%) level II hospitals. In 2018, responding centers reported 81.139 births representing 42.66% of all Romanian births (190.170). There were significant differences between level-III and level-II maternity hospitals regarding the number of births in 2018 (3028.73±1258.38 vs 1983.78±769.99; P=0.006), lowest GA of routinely assisted infants in delivery room (25.07±3.03 weeks vs 30.44±3.28, P<0.001), inborn infants with BW<1500 admitted to neonatal intensive care unit (NICU) in 2018 (66.86±39.14 g vs 22.87±31.50 g; P=0.002), and antenatal counseling of parents before the delivery of a very preterm infant or an infant with expected problems (60% vs 22.2%; P=0.027). There were no significant differences of thermal and umbilical cord management, positive pressure delivery, heart rate assessment between responding centers. The adherence to new guidelines was high among responding centers regarding thermal and umbilical cord management, initial FiO2, but aspects like antenatal counseling, EKG monitoring, laryngeal mask, and heated/humidified gases availability and administration, and simulation-based training require further implementation.

Survey of Neonatal Resuscitation Practices in Metropolitan and Nonmetropolitan Nontertiary Birthing Units in New South Wales and Australian Capital Territory

Objective To describe the neonatal training experience of birth attendants in New South Wales (NSW) and Australian Capital Territory (ACT) and explore the variations in respiratory management and equipment use at birth. Methods We contacted 119 nontertiary units in NSW/ACT by a written survey followed by telephone contact. A set questionnaire was offered, asking for details of the availability and skill levels of staff at neonatal resuscitation, and of the equipment available at all births. Results Staff from 103 out of 119 units (87%) participated in the study. Resuscitation at all metropolitan units was supported by qualified pediatricians whereas midwives provided neonatal resuscitation as the first responder in a nonmetropolitan unit, with support from a general medical practitioner. Twenty-two percent of nontertiary units relied on external agencies or online support for neonatal resuscitation training. Three quarters of the units used a T-piece resuscitator as the primary device to provide positive pressure ventilation, 65.3% of nonmetropolitan units had blenders available, and 19% of units administered some oxygen at initiation of resuscitation. Thirty-eight percent units responded having no prior knowledge of the pressure relief valve setting. Conclusion Equipment and availability of trained personnel for neonatal resuscitation in nontertiary birthing units across NSW and ACT vary widely. The resources to provide training and education are variable.

Neonatal Resuscitation Practices in Turkey: A Survey of the Turkish Neonatal Society and the Union of European Neonatal and Perinatal Societies.

Optimal care in the delivery room is important to decrease neonatal morbidity and mortality. We aimed to evaluate neonatal resuscitation practices in Turkish centers. A cross-sectional survey consisted of a 91-item questionnaire focused on delivery room practices in neonatal resuscitation and was sent to 50 Turkish centers. Hospitals with <2500 and those with ≥2500 births/year were compared. In 2018, approximately 240 000 births occurred at participating hospitals with a median of 2630 births/year. Participating hospitals were able to provide nasal continuous-positiveairway-pressure/high-flow nasal cannula, mechanical ventilation, high-frequency oscillatory ventilation, inhaled nitric oxide, and therapeutic hypothermia similarly. Antenatal counseling was routinely performed on parents at 56% of all centers. A resuscitation team was present at 72% of deliveries. Umbilical cord management for both term and preterm infants was similar between centers. The rate of delayed cord clamping was approximately 60% in term and late preterm infants. Thermal management for preterm infants (<32 weeks) was similar. Hospitals had appropriate equipment with similar rates of interventions and management, except conti nuous-positive-airway-pressure and positive-end-expiratory-pressure levels (cmH2O) used in preterm infants (P = .021, and P = .032). Ethical and educational aspects were also similar. This survey provided information on neonatal resuscitation practices in a sample of hospitals from all regions of Turkey and allowed us to see weaknesses in some fields. Although adherence to the guidelines was high among centers, further implementations are required in the areas of antenatal counseling, cord management, and circulation assessment in the delivery room.

Neonatal resuscitation practices in Italy: a survey of the Italian Society of Neonatology (SIN) and the Union of European Neonatal and Perinatal Societies (UENPS)

BackgroundProviding appropriate care at birth remains a crucial strategy for reducing neonatal mortality and morbidity. We aimed to evaluate the consistency of practice and the adherence to the international guidelines on neonatal resuscitation in level-I and level-II Italian birth hospitals.MethodsThis was a cross-sectional electronic survey. A 91-item questionnaire focusing on current delivery room practices in neonatal resuscitation was sent to the directors of 418 Italian neonatal facilities.ResultsThe response rate was 61.7% (258/418), comprising 95.6% (110/115) from level-II and 49.0% (148/303) from level-I centres. In 2018, approximately 300,000 births occurred at the participating hospitals, with a median of 1664 births/centre in level-II and 737 births/centre in level-I hospitals. Participating level-II hospitals provided nasal-CPAP and/or high-flow nasal cannulae (100%), mechanical ventilation (99.1%), HFOV (71.0%), inhaled nitric oxide (80.0%), therapeutic hypothermia (76.4%), and extracorporeal membrane oxygenation ECMO (8.2%). Nasal-CPAP and/or high-flow nasal cannulae and mechanical ventilation were available in 77.7 and 21.6% of the level-I centres, respectively. Multidisciplinary antenatal counselling was routinely offered to parents at 90.0% (90) of level-II hospitals, and 57.4% (85) of level-I hospitals (p < 0.001). Laryngeal masks were available in more than 90% of participating hospitals while an end-tidal CO2 detector was available in only 20%. Significant differences between level-II and level-I centres were found in the composition of resuscitation teams for high-risk deliveries, team briefings before resuscitation, providers qualified with full resuscitation skills, self-confidence, and use of sodium bicarbonate.ConclusionsThis survey provides insight into neonatal resuscitation practices in a large sample of Italian hospitals. Overall, adherence to international guidelines on neonatal resuscitation was high, but differences in practice between the participating centres and the guidelines exist. Clinicians and stakeholders should consider this information when allocating resources and planning perinatal programs in Italy.

Neonatal Resuscitation Practices in Europe: A Survey of the Union of European Neonatal and Perinatal Societies

Background: We aimed to evaluate the policies and practices about neonatal resuscitation in a large sample of European hospitals. Methods: This was a cross-sectional electronic survey. A 91-item questionnaire focusing on the current delivery room practices in neonatal resuscitation domains was individually sent to the directors of 730 European neonatal facilities or (in 5 countries) made available as a Web-based link. A comparison was made between hospitals with ≤2,000 and those with >2,000 births/year and between hospitals in 5 European areas (Eastern Europe, Italy, Mediterranean countries, Turkey, and Western Europe). Results: The response rate was 57% and included participants from 33 European countries. In 2018, approximately 1.27 million births occurred at the participating hospitals, with a median of 1,900 births/center (interquartile range: 1,400–3,000). Routine antenatal counseling (p < 0.05), the presence of a resuscitation team at all deliveries (p < 0.01), umbilical cord management (p < 0.01), practices for thermal management (p < 0.05), and heart rate monitoring (p < 0.01) were significantly different between hospitals with ≤2,000 births/year and those with >2,000 births/year. Ethical and educational aspects were similar between hospitals with low and high birth volumes. Significant variance in practice, ethical decision-making, and training programs were found between hospitals in 5 different European areas. Conclusions: Several recommendations about available equipment and clinical practices recommended by the international guidelines are already implemented by centers in Europe, but a large variance still persists. Clinicians and stakeholders should consider this information when allocating resources and planning European perinatal programs.

Facility and care provider emergency preparedness for neonatal resuscitation in Kano, Nigeria.

The knowledge, attitude, and practice of emergency neonatal resuscitation are critical requirements in any facility that offers obstetric and neonatal services. This study aims to conduct a needs assessment survey and obtain individual and facility-level data on expertise and readiness for neonatal resuscitation. We hypothesize that neonatal emergency preparedness among healthcare providers in Kano, Nigeria is associated with the level of knowledge, attitudinal disposition, practice and equipment availability at the facility level. A semi-structured, self-administered questionnaire was administered to a cross-section of health providers directly involved with neonatal care (n = 112) and attending a neonatal resuscitation workshop in Kano state. Information regarding knowledge, attitude, practice and facility preparedness for neonatal resuscitation was obtained. Bloom's cut-off score and a validated basic emergency obstetric and neonatal care assessment tool were adopted to categorize outcomes. Multivariable logistic regression was employed to determine independent predictors of knowledge and practice. Almost half (48% and 42% respectively) of the respondents reported average level of self-assessed knowledge and comfort during resuscitation. Only 7% (95% CI:3.2-13.7) and 5% (95% CI:2.0-11.4) of health providers demonstrated good knowledge and practice scores respectively, with an overall facility preparedness of 46%. Respondents' profession as a physician compared to nurses and midwives predicted good knowledge (aOR = 0.08, 95% CI: 0.01-0.69; p = 0.01), but not practice. Healthcare provider's knowledge and practice including facility preparedness for emergency neonatal resuscitation were suboptimal, despite the respondents' relatively high self-assessed attitudinal perception. Physicians demonstrated higher knowledge compared to other health professionals. The low level of respondents' awareness, practice, and facility readiness suggest the current weak state of secondary health systems in Kano.

Magnitude and associated factors of neonatal resuscitation among health care providers in selected public hospitals of Addis Ababa, Ethiopia, 2022. Multi center cross-sectional study

Background: The neonatal stage is one of the most vulnerable in a child&#39;s existence due to the high risks of mortality and illness during such a time. One-fourth of newborn mortality worldwide is caused by asphyxia, with Ethiopia bearing a disproportionately large share of this burden among low- and middle-income countries. Poor resuscitation brought on by inexperienced medical staff had a significant impact on this asphyxia-related mortality and morbidity. The aim of the study is to assess magnitude & associated factors toward neonatal resuscitation among nurses working in public hospitals in Addis Ababa, Ethiopia. Methods: An institution-based cross-sectional study was conducted in selected hospitals in Addis Ababa, Ethiopia. A total of 409 health professionals, including nurses, midwives, general practitioners, interns, residents, and obstetric gynecologists, worked in selected hospitals for this study. Data was collected using validated self-administered questionnaires. Bivariate analysis was used to see the association between each independent variable and the outcome variable, and multivariable logistic regression analysis was carried out to determine the effect of various factors on the outcome variable. All variables with a p-value ≤ 0.25 were taken into the multivariable model to control for all possible confounders. Results: A total of 409 healthcare professionals with a 100% response rate were included. The majority of 357 (87.3%) of the participants had adequate knowledge, and 365 (89.2%) had good practice in neonatal resuscitation. In this study, the odds of health care providers having work experience greater than 5 years were 3.14 (AOR=3.14, 95% CI: 1.20-8.19), receiving neonatal resuscitation training was 2.68 (AOR=2.68, 95% CI: 1.02-7.03), having adequate knowledge about neonatal resuscitation was 6.18 (AOR=6.18, 95% CI: 2.08–18.37), having appropriate suctioning for neonates was 6.14 (AOR=6.14, 95% CI: 2.39-15.74), and neonates during resuscitation placed under neutral positioning were 3.44 (AOR=3.44, 95% CI: 1.45-8.16) significantly associated with practice of neonatal resuscitation. Conclusion and Recommendation: The overall knowledge and practice score of health professionals was good. Hospital managers and decision makers also need to provide periodic supportive supervision and refreshment training to update knowledge and practice of HCPs.

A Pre-experimental Study to Assess the Effectiveness of NRP Training Programme on the Knowledge and Skills regarding Neonatal Resuscitation Practice among BSc Nursing Interns in Selected Colleges of Nursing, District Faridkot, Punjab, India

Introduction: Neonatal resuscitation (NR) is a paediatric emergency procedure used to resuscitate a baby who is unable to begin or sustain regular breathing and respiration. Nurses have a central part in neonatal resuscitation and avoiding complications. This study has been done to assess the knowledge and skills of BSc Nursing interns regarding neonatal resuscitation practice (NRP).Method: The current study was done following a quantitative research approach and pre-experimental with one group pre-test post-test design. 60 BSc Nursing interns of a selected college of district Faridkot, Punjab were selected using purposive sampling technique. A knowledge questionnaire and observational checklist were used to assess the knowledge and skills regarding NRP. A post-test was conducted on the 8th day after the administration of an educational training programme regarding NRP.Results: The result revealed that there was a significant improvement in knowledge and skills of BSc Nursing interns after the administration of educational training programme regarding neonatal resuscitation practice. Paired t-test was used to check the effectiveness of the educational training programme and t value for knowledge and skills were found statistically significant at p value &lt; 0.001.Conclusion: Educational training programme regarding NRP is effective in improving the knowledge and skills of BSc Nursing interns.

Neonatal resuscitation practices in Uganda: a video observational study

BackgroundNeonatal mortality, often due to birth asphyxia, remains stubbornly high in sub-Saharan Africa. Guidelines for neonatal resuscitation, where achieving adequate positive pressure ventilation (PPV) is key, have been implemented in...

Singapore Neonatal Resuscitation Guidelines 2021.

Neonatal resuscitation is a coordinated, team-based series of timed sequential steps that focuses on a transitional physiology to improve perinatal and neonatal outcomes. The practice of neonatal resuscitation has evolved over time and continues to be shaped by emerging evidence as well as key opinions. We present the revised Neonatal Resuscitation Guidelines for Singapore 2021. The recommendations from the International Liaison Committee on Resuscitation Neonatal Task Force Consensus on Science and Treatment Recommendations (2020) and guidelines from the American Heart Association and European Resuscitation Council were compared with existing guidelines. The recommendations of the Neonatal Subgroup of the Singapore Resuscitation and First Aid Council were derived after the work group discussed and appraised the current available evidence and their applicability to local clinical practice.

Impact of neonatal resuscitation changes on outcomes\xa0of very-low-birth-weight infants

The improvement of delivery room care, according to the 2015 International Consensus, may affect neonatal outcome, especially in very-low-birth-weight infants. We aimed to investigate the current practice of neonatal resuscitation by year and analyze the association with neonatal outcomes. A total of 8142 very-low-birth-weight infants, registered in the Korean Neonatal Network between 2014 and 2017 were included. A significant decreasing trend of intubation (64.5% vs 55.1%, P < 0.0001) and markedly increasing trend of positive pressure ventilation (PPV) (11.5% vs 22.9%, P < 0.0001) were noted. The annual PPV rate differed significantly by gestation (P < 0.0001). The highest level of resuscitation was also shown as an independent risk factor for mortality within 7 days and for bronchopulmonary dysplasia (BPD), intraventricular hemorrhage (IVH), and periventricular leukomalacia. PPV and intubation were associated with significantly decreased risk of mortality and morbidities compared to epinephrine use. When considering association, the incidence of mortality within 7 days, IVH, PVL, and BPD or mortality showed significant differences by combination of year, gestational age, and level of resuscitation. According to updated guidelines, changes in the highest level of resuscitation significantly associated with reducing mortality and morbidities. More meticulous delivery room resuscitation focusing on extreme prematurity is needed.

Mapping Evidence of Neonatal Resuscitation Training on the Practices of Unskilled Birth Attendants in Low-Resource Countries: Protocol for a Scoping Review.

BackgroundCompetence in neonatal resuscitation of the newborn is very critical to ensure the safety and well-being of newborn infants. The acquisition of neonatal resuscitation skills by birth attendants improves self-efficacy, thereby reducing neonatal mortality as a result of asphyxia. Approximately one-quarter of all neonatal deaths globally are caused by birth asphyxia. The need for neonatal resuscitation is most imperative in resource-constrained settings, where access to intrapartum obstetric care is inadequate.ObjectiveThis protocol describes the methodology of a scoping review on evidence of training in neonatal resuscitation and its association with practice in low-resource countries. The aim of the review is to map the available evidence of neonatal resuscitation training on the practices of unskilled birth attendants.MethodsThe scoping review will use the Population, Concept, and Context (PCC) framework proposed by Arksey and O’Malley, refined by Levac et al, and published by Joanna Briggs Institute, while following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. The search strategy was developed with the assistance of the college librarian. A number of databases of peer-reviewed research (PsycINFO and Wiley Online Library [via EBSCOhost], PubMed, MEDLINE with full text, Google Scholar [via ScienceDirect], and CINAHL Plus with full text [via EBSCOhost]) and databases committed to grey literature sources will be searched, and reference extraction will be performed. Two independent reviewers will screen and extract data, and discrepancies will be resolved by a third reviewer. The extracted data will undergo a descriptive analysis of contextual data and a quantitative analysis using appropriate statistical methods.ResultsData relating to neonatal resuscitation training and practices in low-resource settings will be extracted and included for analysis. We expect that the review will be completed 12 months from the publication of this protocol.ConclusionsThis scoping review will focus on the review of evidence and provide an insight into the existing literature to guide further research and identify implementation strategies to improve the practices of unskilled birth attendants through the acquisition of skills and self-efficacy in neonatal resuscitation. The results of this review will be presented at relevant conferences related to newborn and child health and neonatal nursing studies and published in a peer-reviewed journal.International Registered Report Identifier (IRRID)DERR1-10.2196/18935

Neonatal Sepsis Risk Factors in Public Hospitals in Wollega Zones, Ethiopia

Background Globally, neonatal death accounts for almost half of the under-five children’s mortality rate. In Ethiopia, neonatal sepsis is among the leading causes of neonatal morbidity and mortality. Several studies had assessed the prevalence and associated factors of neonatal sepsis in Ethiopia. However, limited studies examined the risk factors of neonatal sepsis. Thus, this study aimed to assess risk factors for neonatal sepsis among neonates admitted to the neonatal intensive care unit of the selected public hospitals in Wollega Zones. Methods A hospital-based unmatched case-control study was conducted in public hospitals in Wollega zones among 300 newborns admitted to neonatal intensive care units with their index mothers. Neonatal sepsis was diagnosed by a physician based on hematologic records and newborn danger signs. Neonates who were diagnosed for neonatal sepsis were recorded to cases; meanwhile, controls were who had not had sepsis. The consecutive sampling technique was employed to collect data from the study subjects using a 1:1 ratio for cases and controls. The data were entered into Epi Data version 3.1 and exported to SPSS version 20 for analysis. The binary logistic regression model was used to examine the association between dependent and independent variables. Variables were considered as an independent risk factor of neonatal sepsis if the p-value is <0.05 in stepwise backward analysis in multivariable logistic regression. Findings Three hundred neonates with their index mothers (150 cases and 150 controls) were included in this study. Multivariable logistic regression analysis showed that mothers who had experienced premature rupture of the membrane [AOR=2.94, 95% CI(1.39-6.06)], mothers who had a history of UTI/STI [AOR=2.11, 95% CI(1.06-4.19)], neonates’ who had APGAR scores of <7 at the fifth minute [AOR=3.69, 95% CI(2.08-6.53)] and neonates who was resuscitated at birth [AOR=2.93, 95% CI(1.67-5.14)] were the independent risk factors of neonatal sepsis to neonates admitted to neonatal intensive care units. Conclusions This study highlights both maternal and neonatal factors contributing to neonatal sepsis. Maternal counseling, early identification and prompt management of maternal urinary tract infections/sexually transmitted infections during antenatal care service should be emphasized. Also, enhancing safe neonatal resuscitation and infection prevention practice of delivery unit staff through provision of refreshment course. DOI: 10.7176/JHMN/87-02 Publication date: March 31 st 2021

Perinatal Counseling at the Margin of Gestational Viability: Where We’ve Been, Where We’re Going, and How to Navigate a Path Forward

Perinatal Counseling at the Margin of Gestational Viability: Where We’ve Been, Where We’re Going, and How to Navigate a Path Forward

REFINE (Rapid Feedback for quality Improvement in Neonatal rEsuscitation): an observational study of neonatal resuscitation training and practice in a tertiary hospital in Nepal

BackgroundSimulation-based training in neonatal resuscitation is more effective when reinforced by both practice and continuous improvement processes. We aim to evaluate the effectiveness of a quality improvement program combined with an innovative provider feedback device on neonatal resuscitation practice and outcomes in a public referral hospital of Nepal.MethodsA pre- and post-intervention study will be implemented in Pokhara Academy of Health Sciences, a hospital with 8610 deliveries per year. The intervention package will include simulation-based training (Helping Babies Breathe) enhanced with a real-time feedback system (the NeoBeat newborn heart rate meter with the NeoNatalie Live manikin and upright newborn bag-mask with PEEP) accompanied by a quality improvement process. An independent research team will collect perinatal data and conduct stakeholder interviews.DiscussionThis study will provide further information on the efficiency of neonatal resuscitation training and implementation in the context of new technologies and quality improvement processes.Trial registrationhttps://doi.org/10.1186/ISRCTN18148368, date of registration-31 July 2018

Current Practices and Updates in Neonatal Resuscitation

To outline our current neonatal resuscitation practices and discuss changes that have occurred in the field since the International Liaison Committee on Resuscitation (ILCOR) guidelines were published in 2015. There have been interesting developments in delayed cord clamping, heart rate assessments, and oxygen delivery. New developments continue to emerge in the field of neonatal resuscitation, some of which have been adopted into mainstream practice, while others still require more research to establish efficacy and safety.

Knowledge of General Practitioner Doctors and Midwives Who Has and Has Not Attended Neonatal Resuscitation Course Has No Significant Difference

Introduction: Infant death is most prominent in the neonatal period. The success of neonatal resuscitation practice has many contributing factors. One of which is the health workers’ knowledge of the Neonatal Resuscitation Program (NRP) algorithm. Therefore, it is necessary to conduct studies to evaluate the health workers’ knowledge of the Neonatal Resuscitation Program who are educated in neonatal resuscitation course and has taken part in Neonatal Life Support practice in primary health care (PHC) Objective: This study aims to analyze the knowledge of general practitioners and midwives who has or has not attended in neonatal resuscitation course in Surabaya PHC Methods and Materials: this research is descriptive, cross-sectional research. All Basic Emergency Obstetric and Newborn Care (BEmONC) PHC in Surabaya which are Jagir PHC, Banyu Urip PHC, Medokan Ayu PHC, Tanah kali Kedinding PHC, Tanjungsari PHC, Balongsari PHC, Sememi PHC, Simomulyo PHC is included in this research from 2018 to 2019. A nine-item questionnaire referenced from The Textbook of Neonatal Resuscitation 7th Edition is given to ten respondents in each BEmONC PHC. Results and Discussion: from the total sample of 78 respondents, 32 (41,0%) receive a high score, 20 (25,7%) receive a middle score, and 26 (33,3%) receive a low score. The data shows that there is no significant score difference between respondents who has or has not participate in the NRP course (p=0,419). Conclusion: There is no correlation between difference knowledge midwives and general practitioners who had and had not attended neonatal resuscitation training at basic emergency obstetric and newborn care in public health center Surabaya.

Effect of COVID-19 Precautions on Neonatal Resuscitation Practice: A Balance Between Healthcare Provider Safety, Infection Control, and Effective Neonatal Care.

Adaptations have been proposed for resuscitation of infants born to women with COVID-19, to protect health care providers, maintain infection control, and limit post-natal transmission. Changes especially impact respiratory procedures, personal protective equipment (PPE) use, resuscitation environments, teamwork, and family involvement. Adding viral filters to ventilation devices and modifications to intubation procedures might hinder effective ventilation. PPE could delay resuscitation, hinder task performance, and degrade communication. Changes to resuscitation locations and team composition alter workflow and teamwork. Physical distancing measures and PPE impede family-integrated care. These disruptions need to be considered given the uncertainty of vertical transmission of SARS-CoV-2.