Neonatal Resuscitation Skills Research Articles

Extending "Helping Babies Breathe" to an Academic Setting in Fiji: A Project Involving American Nursing Faculty and Graduate and Undergraduate Nursing Students.

Approximately 2.5 million neonates died worldwide in 2018. Over one quarter of neonatal deaths are caused by birth asphyxia. Helping Babies Breathe (HBB) was created to teach basic neonatal resuscitation steps in limited-resource settings. Fifteen Fijian faculty members attended a master teacher class. Nine undergraduate nursing students from the western United States assisted in teaching two HBB classes for Fijian nursing students. Fijian faculty and student knowledge increased significantly posteducation. Educational settings provide ideal locations for future nurses to learn and practice evidence-based neonatal resuscitation skills. Implementing HBB in an academic setting, though novel, may ensure educators are familiar with current guidelines.

Efficacy of pedagogical framework in neonatal resuscitation skill learning in a resource-limited setting: a randomized controlled trial

BackgroundThe educational efficacy in neonatal resuscitation relies on the subject and teaching strategies. Therefore, it is imperative to test diverse educational methods if they are more instructive to engage students in active learning and practicing knowledge. Hence, the present study aims to investigate the efficacy of a pedagogical framework in neonatal resuscitation skill learning among nursing students in a resource-limited setting.MethodsA single-blind randomized controlled trial was conducted between October 2020 to March 2021. Sixty nursing students in the 3rd and 4th year of professional training were randomly allocated to the pedagogy and the traditional group. The pedagogy group learned via 6-step LSPPDM (Learn, See, Practice, Prove, Do, Maintain) pedagogy including lectures, video, clinical observation, skill sessions under supervision, and self-directed practice. The traditional group learned through 2-step (Learn, Practice) method that included lectures and skill sessions under supervision. The outcomes measured included technical and non-technical skills in neonatal resuscitation. The technical skill deals with steps such as stimulation, ventilation, oxygenation, intubation, chest compression, medications, and reporting. Non-technical skills refer to teamwork skills that focus on the interaction between leader and helper. Both skills were measured through previously published validated tools two times before and after the intervention by blinded assessors in a simulated delivery room.ResultsOverall, the skill was significantly improved in both groups after intervention. Yet, the results showed that the mean difference of technical skill score in the pedagogy group (24.3 ± 3.5) was significantly higher (p < 0.001) compared to the traditional group (16.2 ± 2.4). Likewise, the mean difference of non-technical skill score in the pedagogy (36.9 ± 1.9) was highly significant (p < 0.001) compared to the traditional group (31.2 ± 1.7).ConclusionsThe LSPPDM pedagogy was found more effective in enhancing technical and non-technical skills in neonatal resuscitation compared to the traditional method. The results of this study support the efficacy of the 6-step LSPPDM pedagogy in the education of nursing students regarding neonatal resuscitation in a resource-limited setting.Trial registrationProspectively registered at ClinicalTrials.gov (NCT04748341).

EHBB: a randomised controlled trial of virtual reality or video for neonatal resuscitation refresher training in healthcare workers in resource-scarce settings

ObjectiveTo assess the impact of mobile virtual reality (VR) simulations using electronic Helping Babies Breathe (eHBB) or video for the maintenance of neonatal resuscitation skills in healthcare workers in resource-scarce...

Does high fidelity neonatal resuscitation simulation increase salivary cortisol levels of health care providers?

The use of simulation-based medical education is strongly recommended to insure neonatal resuscitation skills for health caregivers. High fidelity simulation was executed to allow the evaluation of technical and non-technical skills. Salivary cortisol level was considered reliable biomarkers of adrenocortical activity and useful tool to learning assessment and stress response. Our primary aim was to test changes in salivary cortisol levels before and after the simulation for neonatal resuscitation between high and low fidelity setting. Secondary aim was to evaluate salivary cortisol level in the participants, leader and not leader. Fifty-two health care providers were divided in ratio 1:1 into low-fidelity (LF group) and high-fidelity scenario (HF group) of neonatal resuscitation. In each group the participants assumed the role of team leader or not team leader. Salivary samples were collected from all participants 5 minutes before and after each simulation scenario by using oral swab. Analysis of difference was analyzed by Kruskal Wallis Test. Salivary cortisol levels were significantly higher in HF group (N.=26) than LF group (N.=26) before the performance (5.407 mmol/L vs. 3.090 mmol/L; P=0.018). In the HF group, salivary cortisol levels were significantly lower after simulation than before (P=0.007), moreover not team leader showed higher salivary cortisol levels before of the simulation than after (P=0.003). Team leaders showed higher salivary cortisol levels than not team leader after high-fidelity scenario (P=0.039). High-fidelity simulation scenario had a great impact on stress level, furthermore leaders showed higher salivary cortisol levels than not team leaders.

Performance of health workers on neonatal resuscitation care following scaled-up quality improvement interventions in public hospitals of Nepal - a prospective observational study

BackgroundHigh-quality resuscitation among non-crying babies immediately after birth can reduce intrapartum-related deaths and morbidity. Helping Babies Breathe program aims to improve performance on neonatal resuscitation care in resource-limited settings. Quality improvement (QI) interventions can sustain simulated neonatal resuscitation knowledge and skills and clinical performance. This study aimed to evaluate the effect of a scaled-up QI intervention package on the performance of health workers on basic neonatal resuscitation care among non-crying infants in public hospitals in Nepal.MethodsA prospective observational cohort design was applied in four public hospitals of Nepal. Performances of health workers on basic neonatal care were analysed before and after the introduction of the QI interventions.ResultsOut of the total 32,524 births observed during the study period, 3031 newborn infants were not crying at birth. A lower proportion of non-crying infants were given additional stimulation during the intervention compared to control (aOR 0.18; 95% CI 0.13–0.26). The proportion of clearing the airway increased among non-crying infants after the introduction of QI interventions (aOR 1.23; 95% CI 1.03–1.46). The proportion of non-crying infants who were initiated on BMV was higher during the intervention period (aOR 1.28, 95% CI 1.04–1.57) compared to control. The cumulative median time to initiate ventilation during the intervention was 39.46 s less compared to the baseline.ConclusionQI intervention package improved health workers’ performance on the initiation of BMV, and clearing the airway. The average time to first ventilation decreased after the implementation of the package. The QI package can be scaled-up in other public hospitals in Nepal and other similar settings.

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

Self-directed video versus instructor-based neonatal resuscitation training: a randomized controlled blinded non-inferiority multicenter international study.

ObjectiveTo compare the efficacy of video-assisted self-directed neonatal resuscitation skills course with video-assisted facilitator-led course.MethodsThis multicenter, randomized, blinded, non-inferiority-controlled trial compared two methods of teaching basic neonatal resuscitation skills using mask ventilation. Groups of novice providers watched an instructional video. One group received instructor facilitation (Ins-Video). The other group did not (Self-Video). An Objective Structured Clinical Exam (OSCE) measured skills performance, and a written test gauged knowledge.ResultsOne hundred and thirty-four students completed the study. Sixty-three of 68 in the Self-Video Group (92.6%) and 59 of 66 in the Ins-Video Group (89.4%) achieved post-training competency in positive pressure ventilation (primary outcome). OSCE passing rates were low in both groups. Knowledge survey scores were comparable between groups and non-inferior.ConclusionsVideo self-instruction taught novice providers positive pressure ventilation skills and theoretical knowledge, but it was insufficient for mastery of basic neonatal resuscitation in simulation environment.

The effect of an mLearning application on nurses\u2019 and midwives\u2019 knowledge and skills for the management of postpartum hemorrhage and neonatal resuscitation: pre\u2013post intervention study

BackgroundGlobally, mobile learning (mLearning) tools have attracted considerable attention as a means of continuous training for healthcare workers. Rwanda like other low-resource settings with scarce in-service training opportunities requires innovative approaches that adapt technology to context to improve healthcare workers’ knowledge and skills. One such innovation is the safe delivery application (SDA), a smartphone mLearning application for Basic Emergency Obstetric and Neonatal Care (BEmONC) content. This study assessed the effect of the SDA intervention on nurses’ and midwives’ knowledge and skills for the management of postpartum hemorrhage (PPH) and neonatal resuscitation (NR).MethodsThe study used a pre–post test design to compare knowledge and skills of nurses and midwives in the management of PPH and NR at two measurement points: immediately prior to SDA intervention and after 6 months of SDA intervention. The intervention took place in two district hospitals in Rwanda and included 54 participants. A paired-sample t-test was used to measure the pre–post intervention, mean knowledge and skills scores differences. Confidence intervals (CIs) and effect size were calculated. A t-test and a one-way Anova were used to test for potential confounders.ResultsThe analysis included 54 participants. Knowledge scores and skills scores on PPH management and NR increased significantly from baseline to endline measurements. The mean difference for PPH knowledge is 17.1 out of 100; 95% CI 14.69 to 19.49 and 2.6% for PPH skills; 95% CI 1.01 to 4.25. The mean difference for NR knowledge is 19.1 out of 100; 95% CI 16.31 to 21.76 and 5.5% for NR skills; 95% CI 3.66 to 7.41. Increases were unaffected by participants’ attendance to in-service training 6 months prior and during SDA intervention and previous smartphone use. However, pre- and post-intervention skills scores were significantly different by years of experience in obstetric care.ConclusionThe SDA intervention improved the knowledge and skills of nurses and midwives on the management of PPH and NR as long as 6 months after SDA introduction. The results are highly relevant in low-income countries like Rwanda, where quality of delivery care is challenged by a lack of in-service continuous training for healthcare providers.

Digital Simulation Improves, Maintains, and Helps Transfer Health-Care Providers' Neonatal Resuscitation Knowledge.

Purpose: To safely care for their newborn patients, health-care professionals (HCP) must undergo frequent training to improve and maintain neonatal resuscitation knowledge and skills. However, the current approach to neonatal resuscitation simulation training is time and resource-intensive, and often inaccessible. Digital neonatal resuscitation simulation may present a convenient alternative for more frequent training.Method: Fifty neonatal HCPs participated in the study (44 female; 27 nurses, 3 nurse practitioners, 14 respiratory therapists, 6 doctors). This study was conducted at a tertiary perinatal center in Edmonton, Canada from April–August 2019, with 2-month (June–October 2019) and 5-month (September 2019–January 2020) follow-up. Neonatal HCPs were recruited by volunteer sampling to complete a demographic survey, pre-test (baseline knowledge), two digital simulation scenarios (intervention), and post-test (knowledge acquisition). Two months later, participants repeated the post-test (knowledge retention). Five months after the initial intervention, participants completed a post-test using a table-top simulation (knowledge transfer). Longitudinal analyses were used to compare participants' performance over time.Results: Overall the proportion of correct performance increased: 21/50 (42%) passed the pre-test, 39/50 (78%) the post-test, 30/43 (70%) the 2-month post-test, and 32/40 (80%) the 5-month post-test. GLMM and GEE analyses revealed that performance on all post-tests was significantly better than the performance on the pre-test. Therefore, training with the RETAIN digital simulation effectively improves, maintains, and transfers HCPs' neonatal resuscitation knowledge.Conclusions: Digital simulation improved, maintained, and helped transfer HCPs' neonatal resuscitation knowledge over time. Digital simulation presents a promising approach for frequent neonatal resuscitation training, particularly for distance-learning applications.

A Novel Approach to Neonatal Resuscitation Education for Senior Emergency Medicine Residents.

The majority of pediatric visits occur in general emergency departments. Caring for critically ill neonates is a low-frequency but high-stakes event for emergency physicians, which requires specialized knowledge and hands-on training. We describe a novel clinical rotation for emergency medicine (EM) residents that specifically augments skills in neonatal resuscitation through direct participation as a member of the neonatal resuscitation team. The neonatal resuscitation rotation evaluation median score of 4 (interquartile range [IQR] 3,4) was higher compared to all other off-service senior resident rotations combined (median 3, IQR 3,4) for the academic year 2018–2019. Ninety-two percent of residents evaluated the curriculum change as beneficial (median 4, IQR 4,4). The neonatal resuscitation rotation was rated more favorably than the pediatric intensive care rotation (median 4 IQR 3,4 vs median 3, IQR 2, 3) at a tertiary care children’s hospital during the third year. Residency programs may want to consider implementing a directed neonatal resuscitation experience as part of a comprehensive pediatric curriculum for EM residents.

Neonatal complications and its treatment for the better health of neonates at shouq al-kameesh hospital, Libya

Common Neonatal Complications include Neonatal Jaundice, Respiratory distress, Hypoglycemia, sepsis etc. Certain ante-partum and intra-partum risk factors are associated with the need for resuscitation. The main aim of the present study is to assess the common complications of the Neonates in Libya and their managements for healthy sustainable life of the neonates born/admitted at the Shouq Al-kameesh hospital, Al-khoms, Libya. A prospective study was conducted among neonates attended (in-patients and out-patients) at the Shouq Al-kameesh hospital Al-khoms, Libya from April 2018 to March 2020. A total of 294 babies were born/admitted during the period of study. The male-female ratio was 1:0.87. The majority of the babies were aged between 1-30 days. Average birth weights of neonates were 3.2kgs. And 72.10% neonates born with the birth weight of 3-4kgs. Neonatal jaundice (51.01%), sepsis17.00%), low birth weight, preterm birth, TTN, RDS and MAS were the most common morbidities. 89.77% of the babies were undergone phototherapy and 79.91% of babies treated with First line antibiotics. The overall mortality rate was 8.33% with more death during mechanical ventilation usage. Strengthening perinatal care, emergency obstetric care services and neonatal resuscitation skills are necessary to reduce the neonatal complications and mortality.

Pharmacology education on women's health, pregnancy, childbirth and breastfeeding in Midwifery education

Midwives are responsible professionals who support the sexual and reproductive health, rights, and welfare of individuals, families, and communities. In particular, midwives work in partnership with women to provide the necessary support, care and advice needed during pregnancy, childbirth and the postpartum period. Midwives conduct normal births on her own responsibility, support breastfeeding, provide care for newborns and infants, and fully release mother-infant's latent strengths. Midwives also contribute in adopting appropriate preventative measures to promote normal birth and breastfeeding, detecting early signs of complications, and carrying out emergency measures or transferring the patient to other medical care or assistance as needed. In order to provide the best care to mother and infant, midwives should first learn the biological foundations of women's health, pregnancy, childbirth, postpartum, breastfeeding, and infant health. They must also understand the in vivo mechanisms and actions of the key hormones and neurotransmitters in play during the reproductive period. Additionally, midwives need to learn pharmaceutical treatments to complement and support biological function in cases of disorders or impairments occurring in women and infants. Midwives should also be competent in life support skills in obstetrics and neonatal cardiopulmonary resuscitation. The directors of Japanese Maternity Centers sign a contract with obstetricians that permits them to purchase and use emergency medicines. We facilitate midwifery students in their studies of medicine and pharmacology in order to train them to cope with such emergency situations. In this revision of the midwifery curriculum and the continuing education, we hope to create a new midwifery educational program focusing on personalized, client-centered pharmacology, with the ultimate objective to support and maintain the health of women, mothers, infants, child-rearing families, and communities.

DEVELOPMENT OF ASYNCHRONOUS BLENDED LEARNING (ABLE) SKILLS LAB WITH PEER EVALUATION IN MIDWIFERY STUDENTS

Background: Innovations in midwifery education is needed to strengthen students' skills. The Asynchronous Blended Learning (ABLE) Skills Lab model can improve student motivation, retention and skills, but the evaluation is still not optimal. One solution to overcome it by developing of the ABLE Skills Lab with Peer Evaluation model. This study aims to analyze the differences in the improvement of newborn resuscitation skills between the application of the ABLE Skills Lab model with Trainer Evaluation and Peer Evaluation.Methods: This study used a quasy experimental two group pre-post test design. The participants involved in this research were 40 students of the fourth semester students of Diploma III Poltekkes Kemenkes Tasikmalaya who met the inclusion criteria. Subjects were divided into 4 learning groups that randomized into 2 research groups. Data were analyzed using inferential statistics and Rasch modelling. Results: There is no difference in the improvement of newborn resuscitation skills between the application of the ABLE Skills Lab with Trainer Evaluation model and ABLE Skills Lab with Peer Evaluation model (p=0,344). Conclusion: ABLE Skills Lab with Peer Evaluation model has the same ability with Trainer Evaluation model in improving newborn resuscitation skills.ABLE Skills Lab with Peer Evaluation can be an alternative method when there are limited staff / instructors during the learning process without reducing the output produced. Keywords: ABLE skills lab, neonatal resuscitation skills, peer evaluation, trainer evaluation

111. IMPLEMENTATION OF A NEONATAL QUALITY IMPROVEMENT SIMULATION PROGRAM FOR PEDIATRIC RESIDENTS

Background Simulation-Based Medical Education is important in curriculum development and training in order to promote adequate teaching for trainees. At Connecticut Children's, simulation training is incorporated into the inpatient curriculum for pediatric residents with the exception of the neonatal intensive care unit (NICU). By implementing delivery room (DR) simulations, we hope to improve residents’ confidence in neonatal resuscitation skills. Aim Statement From November 2018 to December 2019, we aimed to improve pediatric resident confidence as assessed by serial surveys by 40% and improve Neonatal Resuscitation Program (NRP) skill proficiency measured by the number of correctly performed NRP steps by 25%. Interventions Residents completed a survey before and after their NICU rotation asking the following: I am confident in my ability to 1) perform bag mask ventilation, 2) participate in neonatal mock codes (NMCs), and 3) be team leader during NMCs. We implemented twice monthly DR simulations using standardized cases. Three PDSA cycles were completed. During cycle 1, DR simulations were implemented using laminated cards to present clinical information. A digital app was used in cycle 2 to present vital signs. The 2016 NRP algorithm card was provided for cycle 3 as a tool for reference. Measures Outcome measures included number of correct NRP steps and changes in resident confidence in resuscitation skills. Process measures included time to initiate positive pressure ventilation (PPV), resident participation and time to adequate ventilation. Balancing measures included missed actual deliveries and procedures in the NICU. Results Thirty-one residents (17 PL-1 and 14 PL-2) participated in the project. Residents’ confidence in ability to participate in NMCs increased by 17% and 18% and confidence in ability to lead NMCs increased by 27% and 20% for PL-1 and PL-2, respectively. Overall, residents reported increased confidence in resuscitation skills when comparing pre- and post-survey results. There was no difference in number of correctly performed NRP steps. Mean time to initiate PPV during the first simulation was 99+36.7s and 65.5+46.3s during the second simulation, giving an average decrease in time to initiate PPV of 33.5+44s, (p Conclusions and Next Steps DR simulations increase resident confidence in ability to participate in and lead NMCs. Simulation may increase residents’ proficiency in NRP skills demonstrated by improvement in time to initiate PPV.

Retrospective assessment of neonatal morbidity and mortality in the special care baby unit of a private health facility in Benue State, North Central Nigeria

Background: Newborn morbidity and mortality have remained unacceptably high in developing countries despite consistent efforts at controlling the scourge. Unlike in developed countries where neonatal mortality rate ranges between 1 and 5 per 1000 live births, average neonatal mortality rate in Nigeria is 36 per 1000 live births. The majority of the causes of death are largely preventable with timely low cost interventions. This study was structured to determine the pattern of morbidity and mortality amongst babies admitted in the Special Care Baby Unit of Madonna hospital Makurdi, Nigeria.Methods: The records of neonates admitted into the Special Care Baby Unit (SCBU) over a tenyear period (2005-2015) were retrospectively reviewed. Information obtained included the sex, age at admission, gestational age, birth weight, reasons for admission and outcome of treatment.Results: A total of 1,121 babies were admitted during the period under review. The male female ratio was 1.2:1.The majority of the babies were aged between 2-7 days with a mean 6.17.+ 7.01 The mean weight on admission was 2807+907g. Neonatal sepsis, jaundice, low birth weight and birthasphyxia were the most common morbidities. The overall mortalityrate was 14.1%; however, proportionate mortality due to low birth weight was highest (26.4%), followed by tetanus (23.5%), asphyxia (20.8%), Respiratory tract infection (13.8%), meningitis (13.3%), sepsis (10.3%), jaundice (9.6%), and diarhoea (4.0%)Conclusion: Neonatal mortality rate in the study was high. The major causes of admission are preventable. Strengthening perinatal care, emergency obstetric care services and neonatal resuscitation skills are necessary to reduce the neonatal mortality.&#x0D; Key words: Neonate, Morbidity, Mortality, Nigeria

Unmet goals of neonatal nursing - an observational study

Background: Neonatal nurses are the backbone of any neonatal service, spending maximum time in the care of the sick New-borns in the Neonatal intensive care unit (NICU). Objective of the study was to know about the educational qualification and assess the self-reported confidence in various clinical skills among the nurses working in level 2 &amp; 3 NICUs, preferred learning methodology and assess self-reported stressors among the nurses working in level 2 and level 3 NICUsMethods: This cross-sectional study was done across Level II and Level III Neonatal intensive care units in urban areas of the city of Hyderabad, India over one year from January 2019 to December 2019. Individual questionnaires were distributed to each registered nurse working in the NICU for a minimum duration of six months who were willing to participate.Results: A total of 217 respondents were enrolled. The majority of the nurses were having General Nursing and Midwifery (GNM) qualification 52% (n=112). Nearly 26% (n=58) of the nurses were not comfortable performing bag and mask ventilation. Learning from senior nurses/colleagues as the most preferred mode of learning 45% (n=98). Low salaries 45% (n=98) followed by absence of doctors in emergency situations 37% (n=81) and high documentation (paperwork) 36% (n=78) were most frequently reported stressors.Conclusions: Most of the nursing participants qualified as GNM. Lacking skills of neonatal resuscitation. Mentor based learning needs to be facilitated by raising a cadre of neonatal nursing tutors in various nursing colleges. Paperless monitoring systems and other automation methods should be developed to reduce the documentation work of the staff.

Basic neonatal resuscitation skills of midwives and nurses in Eastern Ethiopia are not well retained: An observational study.

Neonatal resuscitation is a life-saving intervention for birth asphyxia, a leading cause of neonatal mortality. Worldwide, four million neonate deaths happen annually, and birth asphyxia accounts for one million deaths. Improving providers' neonatal resuscitation skills is critical for delivering quality care and for morbidity and mortality reduction. However, retention of these skills has been challenging in developing countries, including Ethiopia. Hence, this study aimed to assess neonatal resuscitation skills retention and associated factors among midwives and nurses in Eastern Ethiopia. An institution-based cross-sectional study was conducted using a pre-tested, structured, observational checklist. A total of 427 midwives and nurses were included from 28 public health facilities by cluster sampling and simple random sampling methods. Data were collected on facility type, availability of essential resuscitation equipment, socio-demographic characteristics of participants, current working unit, years of professional experience, whether a nurse or midwife received refresher training, and skills and knowledge related to neonatal resuscitation. Binary logistic regression was used to analyse the association between neonatal resuscitation skill retention and independent variables. About 11.2% of nurses and midwives were found to have retention of neonatal resuscitation skills. Being a midwife (AOR, 7.39 [95% CI: 2.25, 24.24]), ever performing neonatal resuscitation (AOR, 3.33 [95% CI: 1.09, 10.15]), bachelor sciences degree or above (AOR, 4.21 [95% CI: 1.60, 11.00]), and good knowledge of neonatal resuscitation (AOR, 3.31 [95% CI: 1.41, 7.73]) were significantly associated with skill retention of midwives and nurses. Basic neonatal resuscitation skills of midwives and nurses in Eastern Ethiopia are not well retained. This could increase the death of neonates due to asphyxia. Being a midwife, Bachelor Sciences degree or above educational status, ever performing neonatal resuscitation, and good knowledge were associated with skill retention. Providers should be encouraged to upgrade their educational level to build their skill retention and expose themselves to NR. Further, understanding factors affecting how midwives and nurses gain and retain skills using high-level methodology are essential.

Neonatal Resuscitation: A Blended Learning Curriculum for Medical and Physician Assistant Students.

IntroductionDemonstration of competence in neonatal resuscitation is critical for health care providers who provide newborn care because each year, approximately 400,000 (10%) newborns require resuscitation in delivery rooms across the United States. Therefore, neonatal resuscitation skills certification is provided to graduates entering specific specialties at the beginning of residency and renewed biennially through the American Academy of Pediatrics and the American Heart Association. However, there is no formal curriculum to prepare medical (MD) and physician assistant (PA) students prior to graduation.MethodsWe developed a neonatal resuscitation curriculum for MD and PA students using a blended learning approach. The curriculum included web-based interactive teaching modules, a demonstration video of a mock neonatal resuscitation, and a neonatal resuscitation simulation. Final-year MD and PA students were evaluated using pre-/posttest, a neonatal resuscitation checklist, and an optional survey on interprofessional communication skills, roles, and responsibility.ResultsEighteen health professions learners completed the neonatal resuscitation curriculum. A paired-samples t test was conducted to compare pretest and posttest scores. There was a significant difference in pretest (M = 61.4, SD = 15.3) and posttest (M = 78.6, SD = 8.0) scores, t(17) = −4.7, p < .001. The mean score on the checklist was 79%. Learners strongly agreed/agreed that the simulation improved skills performance (100%), communication skills (92%), and understanding of roles and responsibilities (83%) during a neonatal resuscitation.DiscussionThere were improvements in knowledge, procedural, and interprofessional skills in learners who received the neonatal resuscitation curriculum.

Pre-Training Cognitive and Psychomotor Gaps in Healthcare Worker Neonatal Resuscitation Skills for Helping Babies Breathe – A Report from the eHBB/mHBS Study

Pre-Training Cognitive and Psychomotor Gaps in Healthcare Worker Neonatal Resuscitation Skills for Helping Babies Breathe – A Report from the eHBB/mHBS Study

Adding video-debriefing to Helping-Babies-Breathe training enhanced retention of neonatal resuscitation knowledge and skills among health workers in Uganda: a cluster randomized trial

ABSTRACT Background Skilled birth attendants must be competent to provide prompt resuscitation to save newborn lives at birth. Both knowledge and skills (competence) decline with time after training but the optimal duration for refresher training among frontline-skilled birth attendants in low-resource settings is unknown. Objectives We assessed the effect of an innovative Helping-Babies-Breathe simulation-based teaching method using video-debriefing compared to standard Helping-Babies-Breathe training on 1) neonatal resuscitation knowledge and skills attainment and 2) competence retention among skilled birth attendants in Northern Uganda. Methods A total of 26 health facilities with 86 birth attendants were equally randomised to intervention and control arms. The 2nd edition of the American Association of Pediatrics Helping-Babies-Breathe curriculum was used for training and assessment. Knowledge and skills were assessed pre- and post-training, and during follow-up at 6 months. A mixed effects linear regression model for repeated measures was used to assess the short and long-term effects of the intervention on neonatal resuscitation practices while accounting for clustering. Results Eighty-two (95.3%) skilled birth attendants completed follow-up at 6 months. Approximately 80% of these had no prior Helping-Babies-Breathe training and 75% reported practicing neonatal resuscitation routinely. Standard Helping-Babies-Breathe training with video-debriefing improved knowledge and skills attainment post-training [adjusted mean difference: 5.34; 95% CI: 0.82–10.78] and retention [adjusted mean difference: 2.97; 95% CI: 1.52–4.41] over 6 months post-training compared to standard training after adjusting for confounding and clustering. Factors that reduced knowledge and skills retention among birth attendants were monthly resuscitation of one neonate or more and being in service for more than 5 years. Conclusion Adding video-debriefing to standard Helping-Babies-Breathe training had an effect on birth attendants’ competence attainment and retention over 6 months in Uganda. However, more research is needed to justify the proposed intervention in this context.