Neonatal Resuscitation Training Research Articles

Neonatal resuscitation: EN-BIRTH multi-country validation study

BackgroundAnnually, 14 million newborns require stimulation to initiate breathing at birth and 6 million require bag-mask-ventilation (BMV). Many countries have invested in facility-based neonatal resuscitation equipment and training. However, there is no consistent tracking for neonatal resuscitation coverage.MethodsThe EN-BIRTH study, in five hospitals in Bangladesh, Nepal, and Tanzania (2017–2018), collected time-stamped data for care around birth, including neonatal resuscitation. Researchers surveyed women and extracted data from routine labour ward registers. To assess accuracy, we compared gold standard observed coverage to survey-reported and register-recorded coverage, using absolute difference, validity ratios, and individual-level validation metrics (sensitivity, specificity, percent agreement). We analysed two resuscitation numerators (stimulation, BMV) and three denominators (live births and fresh stillbirths, non-crying, non-breathing). We also examined timeliness of BMV. Qualitative data were collected from health workers and data collectors regarding barriers and enablers to routine recording of resuscitation.ResultsAmong 22,752 observed births, 5330 (23.4%) babies did not cry and 3860 (17.0%) did not breathe in the first minute after birth. 16.2% (n = 3688) of babies were stimulated and 4.4% (n = 998) received BMV. Survey-report underestimated coverage of stimulation and BMV. Four of five labour ward registers captured resuscitation numerators. Stimulation had variable accuracy (sensitivity 7.5–40.8%, specificity 66.8–99.5%), BMV accuracy was higher (sensitivity 12.4–48.4%, specificity > 93%), with small absolute differences between observed and recorded BMV. Accuracy did not vary by denominator option. < 1% of BMV was initiated within 1 min of birth. Enablers to register recording included training and data use while barriers included register design, documentation burden, and time pressure.ConclusionsPopulation-based surveys are unlikely to be useful for measuring resuscitation coverage given low validity of exit-survey report. Routine labour ward registers have potential to accurately capture BMV as the numerator. Measuring the true denominator for clinical need is complex; newborns may require BMV if breathing ineffectively or experiencing apnoea after initial drying/stimulation or subsequently at any time. Further denominator research is required to evaluate non-crying as a potential alternative in the context of respectful care. Measuring quality gaps, notably timely provision of resuscitation, is crucial for programme improvement and impact, but unlikely to be feasible in routine systems, requiring audits and special studies.

P0184 / #1528: THE IMPACT OF NEONATAL RESUSCITATION TRAINING ON NEONATAL RESUSCITATION COMPETENCE OF PAEDIATRIC RESIDENTS AND NEONATAL NURSES IN A MIDDLE INCOME COUNTRY: A QUALITY IMPROVEMENT INITIATIVE

Aims & Objectives: At least 10% of newborns require assistance with breathing; less than 1% require cardiac compressions and/or medications to ensure successful transition. The United Nations’ fourth millennial development goal aimed to reduce under- five mortality by two thirds by 2015. The global under -five mortality declined by 47%; the median mortality doubled to 3.8%. Greater than 1/3 of neonatal deaths occur within 24 hours of birth. Intrapartum complications account for 23% of deaths within the first month. The Third Sustainable Development Goal targets neonatal mortality rate of 12 per 1,000 live births by 2030. Ensuring Neonatal resuscitation competency is therefore essential during Paediatric training. As part of the 2020 strategic plan, a Neonatal Resuscitation training initiative will be introduced at the Univeristy Hospital of the West Indies, to improve the competence at neonatal resuscitation of Paediatric residents and Neonatal nurses by 50%. Methods: Assessment of perceived and observed resuscitation competence of participants prior to and after training during simulated codes and actual resuscitation will be done. Resuscitation competence will be assessed 4 months thereafter. Research Ethics Board approval will be sought. Consent will be obtained. Results: Measures: Process Number of staff receiving training Compliance with NRP algorithm Number of staff using checklist Balancing Inappropriate intubation Prolonged duration of resuscitation Level of confidence in resuscitation Outcome Resuscitation competence of participants immediately and 4 months after training Stakeholder satisfaction with resuscitation skills of participants Conclusions: Implementing a neonatal resuscitation training initiative at the University Hospital of the West Indies will improve competency and confidence in staff

Mindset Moderates Healthcare Providers' Longitudinal Performance in a Digital Neonatal Resuscitation Simulator.

Background: Simulation education can benefit healthcare providers (HCPs) by providing opportunities to practice complex neonatal-resuscitation tasks in low-stake environments. To our knowledge, no study investigated the role of growth mindset on longitudinal performance on neonatal resuscitation before and after simulation-based training.Objectives: This study examines whether 1) the RETAIN digital/table-top simulators facilitate HCPs' neonatal resuscitation knowledge gain, retention, and transfer and 2) growth mindset moderates HCPs' longitudinal performance in neonatal resuscitation.Methods: Participants were n = 50 HCPs in a tertiary perinatal center in Edmonton, Canada. This longitudinal study was conducted in three stages including 1) a pretest and a mindset survey, immediately followed by a posttest using the RETAIN digital simulator from April to August 2019; 2) a 2-month delayed posttest using the same RETAIN neonatal resuscitation digital simulator from June to October 2019; and 3) a 5-month delayed posttest using the low-fidelity table-top neonatal resuscitation digital simulator from September 2019 to January 2020. Three General Linear Mixed Model (GLMM) repeated-measure analyses investigated HCPs' performance on neonatal resuscitation over time and the moderating effect of growth mindset on the association between test time points and task performance.Results: Compared with their pretest performance, HCPs effectively improved their neonatal resuscitation knowledge after the RETAIN digital simulation-based training on the immediate posttest (Est = 1.88, p < 0.05), retained their knowledge on the 2-month delayed posttest (Est = 1.36, p < 0.05), and transferred their knowledge to the table-top simulator after 5 months (Est = 2.01, p < 0.05). Although growth mindset did not moderate the performance gain from the pretest to the immediate posttest, it moderated the relationship between HCPs' pretest and long-term knowledge retention (i.e., the interaction effect of mindset and the 2-month posttest was significant: Est = 0.97, p < 0.05). The more they endorsed a growth mindset, the better the HCPs performed on the posttest, but only when they were tested after 2 months.Conclusions: Digital simulators for neonatal resuscitation training can effectively facilitate HCPs' knowledge gain, maintenance, and transfer. Besides, growth mindset shows a positive moderating effect on the longitudinal performance improvement in simulation-based training. Future research can be conducted to implement growth-mindset interventions promoting more effective delivery of technology-enhanced, simulation-based training and assessment.

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.

Simulation-Based Education in the Training of Newborn Care Providers—A Malaysian Perspective

Simulation-based education (SBE) is increasingly used as an education tool to improve learning for healthcare providers. In newborn care practice, SBE is used in the Neonatal Resuscitation Program (NRP) and training in procedural skills. The NRP is a mandatory course in Malaysia for all house officers (interns) and medical officers (residents) during their pediatric rotation. Almost 30,000 of NRP providers have been trained over the last 5 years. The recent establishment of the Allied Healthcare Center of Excellence (AHCoE), an organization dedicated to promoting SBE, and Malaysian Society for Simulation in Healthcare (MaSSH) aims to enhance the integration of SBE into the healthcare training curriculum and set up a local healthcare simulation educator training program. Our experience in implementing SBE necessitated that we made several important choices. As there was no strong evidence to favor high-fidelity over low-fidelity simulation, and because simulation centers can be very costly to set up with limited resources, we chose SBE mainly in the form of low-fidelity and in situ simulation. We also identified an important developmental goal to train Malaysian instructors on structured debriefing, a critical activity for learning in SBE. Currently, debriefing is often carried out in our centers at an ad hoc basis because of time limitation and the lack of personnel trained. Finally, we aim to implement SBE further in Malaysia, with two axes: (1) the credentialing and recertification of physicians and nurses, and (2) the education of lay caregivers of high-risk infants before discharge from the neonatal intensive care unit.

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.

Lessons Learned from a Collaborative to Develop a Sustainable Simulation-Based Training Program in Neonatal Resuscitation: Simulating Success.

Newborn resuscitation requires a multidisciplinary team effort to deliver safe, effective and efficient care. California Perinatal Quality Care Collaborative’s Simulating Success program was designed to help hospitals implement on-site simulation-based neonatal resuscitation training programs. Partnering with the Center for Advanced Pediatric and Perinatal Education at Stanford, Simulating Success engaged hospitals over a 15 month period, including three months of preparatory training and 12 months of implementation. The experience of the first cohort (Children’s Hospital of Orange County (CHOC), Sharp Mary Birch Hospital for Women and Newborns (SMB) and Valley Children’s Hospital (VCH)), with their site-specific needs and aims, showed that a multidisciplinary approach with a sound understanding of simulation methodology can lead to a dynamic simulation program. All sites increased staff participation. CHOC reduced latent safety threats measured during team exercises from 4.5 to two per simulation while improving debriefing skills. SMB achieved 100% staff participation by identifying unit-specific hurdles within in situ simulation. VCH improved staff confidence level in responding to neonatal codes and proved feasibility of expanding simulation across their hospital system. A multidisciplinary approach to quality improvement in neonatal resuscitation fosters engagement, enables focus on patient safety rather than individual performance, and leads to identification of system issues.

Use of Simulation in Newborn Resuscitation Education: Systematic Review

Objective: Every year, millions of newborns around the world need the help of health professionals to take their first breath. Healthcare professionals need to have comprehensive knowledge and skills of specified in the neonatal resuscitation algorithm to perform life-saving interventions quickly and accurately. However, since neonatal resuscitation is a rather complicated task, deviations from this algorithm are common. In this article, it is aimed to review the current evidence of simulation used to improve neonatal resuscitation training. Methods: This research is the systematic review design and is a qualitative research based on document analysis of the articles. The universe of the study consisted of 116 articles from 2015-2020, accessed from databases such as Medline Complete, Academic Search Complete, Academic Search Ultimate, CINAHL Complete, Directory of Open Access Journals, Google Scholar and Google Scholar. Nine articles that satisfy the criteria for inclusion in this study were evaluated within the scope of the study. Results: Eight of the nine studies included in the study were reported to be in use high reality simulations. In all studies, educational content ranging from theoretical lessons based on neonatal resuscitation guidance and simulated resuscitation training to scenario-based practices were reported. In simulations to evaluate skill performances Megacode scenario was used in five studies, simulator software in one study, and a standard evaluation form in three studies. Conclusion: In the current studies, despite the improvement in knowledge and skill performance immediately after neonatal resuscitation training, the protection of knowledge and skills in the long term is controversial. For this reason, it may be recommended to conduct refresher trainings for the protection of newborn resuscitation knowledge and skills of health care professionals.

Evaluation of Neonatal Resuscitation Knowledge and Procedures According to the “Helping Babies Breathe” (HBB) Program by Qualified Health Care Staff at the Sikasso Hospital Level in Mali

Introduction: Perinatal asphyxia is one of the leading causes of perinatal death. According to the WHO, two thirds of these deaths can be prevented with simple and effective interventions. The HBB (Helping Babies Breathe) program provides effective care for asphyxiant newborns regardless of the level of care. Objective: The objective of our work was to assess the knowledge of neonatal resuscitation equipment and procedures according to the HBB program by qualified nursing staff at the level of referral health structures in the Sikasso region of Mali. Methodology: This is a multicenter cross-sectional survey over a period of 4 months. It was carried out in two maternities and two referral neonatal units in Sikasso. The target population studied was made up of the nursing staff involved in the reception and care of newborns in the delivery room, in postpartum suites and in neonatal departments. Results: Eighty percent (112/141) of targeted caregivers were interviewed. More than half (44%) had more than 6 years of experience in neonatal care. Only 27% had received training in neonatal resuscitation including HBB. The most cited materials used for resuscitation were the mucus aspirator (82%), the ventilation bag (67%) and the heated table (60%). The bestknown resuscitation procedures were airway aspiration (82%), mask ventilation (60%), and hypothermia control (48%). Conclusion: Knowledge of newborn resuscitation remains very insufficient in the reference structures in Sikasso. It is necessary to implement a strategic plan for continuous training of staff with periodic monitoring in health structures.

Contribution of Clinical Simulation in Neonatal Resuscitation Training at the University Teaching Hospital (UTH) of Bogodogo in Ouagadougou, Burkina Faso

Objective: To study the place of simulation in the learning of newborn resuscitation among seventh year medical students at the University Hospital of Bogodogo in Ouagadougou, Burkina Faso. Material and Method: Our study took place in the obstetrical gynaecology department of the University Hospital Centre of Bogodogo (UTH-B) from 15 December 2018 to 15 March 2019. We randomly selected two groups of students, with no stimulation. We recorded a theoretical questionnaire to all students at the beginning and then carried out two stimulation sessions at 1 month intervals in the competence laboratory of the National School of Public Health. Then we evaluated the theoretical and practical progress of the students over time. We analyzed our data through the Epi info software in version 3.5.1. Results: The two simulation sessions positively influenced the theoretical knowledge of neonatal intensive care for 7th year students (p = 0.0391). Neonatal resuscitation management by students is better from one simulation session to another with a statistically significant difference (p = 0.0001). Conclusion: Our study of 7th grade students showed the importance of this tool in their practical training at the University Hospital of Bogodogo. Advocacy must be organized for its acquisition in the university hospitals of Burkina Faso.

Knowledge and associated factors towards neonatal resuscitation among nurses and midwives at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia

IntroductionNeonatal resuscitation is an intervention performed on a newborn baby who has difficulty with airway breathing and circulation. As the first few moments of a newborn's life are the most critical, it needs effective emergency care to prevent lifelong consequences. The quality of resuscitation and stabilization of a neonate immediately after birth has a significant effect on neonatal morbidity and mortality. So, determining the knowledge level of nurses and midwives about neonatal resuscitation is crucial to minimize neonatal-associated health complications. This study aimed to assess knowledge and associated factors of neonatal resuscitation among nurses and midwives at the University of Gondar Comprehensive Specialized Hospital in North West Ethiopia 2020. MethodInstitution-based cross-sectional study was conducted at the University of Gondar specialized hospital in December 2020. Three hundred and sixty study participants were selected using a simple random sampling technique. A pretested questionnaire was used to collect data from study participants. Reports of the knowledge of participants of neonatal resuscitation were measured using 25 performance questions. Data were entered and checked with Epi-data version 4.6 and was exported to SPSS version 23. Binary logistic regression analysis was performed to identify factors associated with the knowledge of participants; a value<0.05 with a 95% confidence interval was used to declare a statistically significant association. ResultThe knowledge level of the nurses and midwives was 46.5% (95% CI 41.4%-51.7%). Sex (AOR = 2.33, 95% CI (1.38–3.95)), participants in neonatal resuscitation training (AOR = 7.81, 95% CI (4.37–13.96)), and the field of study or profession (AOR = 0.142, 95% CI (0.63–0.32)) were the significant factors associated with the knowledge of nurses and midwives of neonatal resuscitation. Conclusion and recommendationThe knowledge level of nurses and midwives was low. It is recommended that nurse’s and midwives’ knowledge be improved by providing regular training on neonatal resuscitation for both males and females, as well as for midwives and comprehensive nurses.

Basic neonatal resuscitation: retention of knowledge and skills of primary health care workers in Port Harcourt, Rivers State, Southern Nigeria.

Introductionbirth attendants' retention of knowledge and skills of neonatal resuscitation post-training can prevent birth asphyxia by repeatedly applying neonatal resuscitation guidelines. This study assessed primary healthcare workers' retention of knowledge and skills of basic neonatal resuscitation.Methodsin 28 primary health centres, 106 birth attendants had their knowledge and skills assessed following a one-day neonatal resuscitation training. The evaluation was before, immediately after training, at three months (a subset of participants) and six months. Paired t-tests were used to compare mean scores at two different evaluation times.Resultsthe mean baseline knowledge and skills scores were 35.22% ± 12.90% and 21.40% ± 16.91% respectively. Immediately after training, it increased to 81.48% ± 7.05% and 87.40% ± 13.97% respectively (p=0.0001). At three months, it decreased to 55.37% ± 20.50% and 59.11% ± 25.55% respectively (p=0.0001), at six months it was 55.77% ± 14.28% and 60.38% ± 19.79% respectively (p=0.0001). Following immediate post-training at 6 months, knowledge and skills scores increased to 94.91 ± 7.28% and 96.02 ± 4.50% respectively (p=0.0001). No participant had adequate knowledge and one had adequate skills at baseline. The proportion of those with adequate knowledge and skills markedly increased immediate post-training but decreased remarkably at three-month and at six-month evaluations respectively. 99.1% had adequate knowledge and all had adequate skills immediate post-training at 6 months.Conclusionneonatal resuscitation training led to an improvement in knowledge and skills with suboptimal retention at three to six months post-training. Re-training improved knowledge and skills. We recommend that the retention of knowledge and skills could improve by retraining and mentoring at least 3-6 monthly.

Telesimulation as a modality for neonatal resuscitation training

ABSTRACT Introduction: Telesimulation may allow simulationists to continue with essential simulation-based training programs during the COVID-19 pandemic. Hence, we investigated the feasibility of telesimulation for neonatal resuscitation training, assessed participants’ attitudes towards telesimulation as well as its effect on neonatal resuscitation knowledge, and compared results between medical students and neonatal nurses. Methods: For this prospective observational pilot study, medical students and neonatal nursing staff were recruited on a voluntary basis. Pre- and post-training knowledge was assessed using a 20-question questionnaire. Following the educational intervention, participants further answered a six-item questionnaire on their perception of telesimulation. For the telesimulation session, participants received a simulation package including a low-fidelity mannequin and medical equipment. The one-hour telesimulation session was delivered by an experienced instructor and broadcasted via Cisco Webex for groups of 2–3 participants, covering all elements of the neonatal resuscitation algorithm and including deliberate technical skills practice. Results: Nine medical students and nine neonatal nurses participated in a total of seven telesimulation sessions. In general, participants enjoyed the telesimulation session, acknowledged a positive learning effect and found telesimulation suitable for neonatal resuscitation training, but were critical of potential technical issues, training logistics, and the quality of supervision and feedback. Neonatal resuscitation knowledge scores increased significantly after the educational intervention both for medical students and nurses. Conclusions: Telesimulation is feasible for neonatal resuscitation training and associated with significant improvements in knowledge of current resuscitation guidelines, without differences between medical students and neonatal nurses.

Health Care Providers' Performance, Mindset, and Attitudes Toward a Neonatal Resuscitation Computer-Based Simulator: Empirical Study.

BackgroundNeonatal resuscitation involves a complex sequence of actions to establish an infant’s cardiorespiratory function at birth. Many of these responses, which identify the best action sequence in each situation, are taught as part of the recurrent Neonatal Resuscitation Program training, but they have a low incidence in practice, which leaves health care providers (HCPs) less prepared to respond appropriately and efficiently when they do occur. Computer-based simulators are increasingly used to complement traditional training in medical education, especially in the COVID-19 pandemic era of mass transition to digital education. However, it is not known how learners’ attitudes toward computer-based learning and assessment environments influence their performance.ObjectiveThis study explores the relation between HCPs’ attitudes toward a computer-based simulator and their performance in the computer-based simulator, RETAIN (REsuscitation TrAINing), to uncover the predictors of performance in computer-based simulation environments for neonatal resuscitation.MethodsParticipants were 50 neonatal HCPs (45 females, 4 males, 1 not reported; 16 respiratory therapists, 33 registered nurses and nurse practitioners, and 1 physician) affiliated with a large university hospital. Participants completed a demographic presurvey before playing the game and an attitudinal postsurvey after completing the RETAIN game. Participants’ survey responses were collected to measure attitudes toward the computer-based simulator, among other factors. Knowledge on neonatal resuscitation was assessed in each round of the game through increasingly difficult neonatal resuscitation scenarios. This study investigated the moderating role of mindset on the association between the perceived benefits of understanding the terminology used in the computer-based simulator, RETAIN, and their performance on the neonatal resuscitation tasks covered by RETAIN.ResultsThe results revealed that mindset moderated the relation between participants’ perceived terminology used in RETAIN and their actual performance in the game (F3,44=4.56, R2=0.24, adjusted R2=0.19; P=.007; estimate=–1.19, SE=0.38, t44=–3.12, 95% CI –1.96 to –0.42; P=.003). Specifically, participants who perceived the terminology useful also performed better but only when endorsing more of a growth mindset; they also performed worse when endorsing more of a fixed mindset. Most participants reported that they enjoyed playing the game. The more the HCPs agreed that the terminology in the tutorial and in the game was accessible, the better they performed in the game, but only when they reported endorsing a growth mindset exceeding the average mindset of all the participants (F3,44=6.31, R2=0.30, adjusted R2=0.25; P=.001; estimate=–1.21, SE=0.38, t44=−3.16, 95% CI –1.99 to –0.44; P=.003).ConclusionsMindset moderates the strength of the relationship between HCPs’ perception of the role that the terminology employed in a game simulator has on their performance and their actual performance in a computer-based simulator designed for neonatal resuscitation training. Implications of this research include the design and development of interactive learning environments that can support HCPs in performing better on neonatal resuscitation tasks.

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

Factors associated with neonatal resuscitation knowledge and comfort across academic anesthesia institutions

Background Neonatal resuscitation training is a requirement for all obstetric anesthesia fellows. However, while the majority of anesthesiologists who work on labor and delivery report having been involved in the resuscitation of a newborn, most do not have NRP training. Objective By studying a national cohort of anesthesiologists, our objective was to identify factors associated with knowledge and comfort with neonatal resuscitation and to inform decisions about neonatal resuscitation in obstetric anesthesia fellowship training. Materials and methods After receiving exempt status, a survey assessing knowledge and comfort with neonatal resuscitation was sent to US academic institutions. Univariable and multiple variable regression analyses were performed to assess factors associated with knowledge and comfort. All statistical analyses were performed using R software (R version 3.4.3 [2017-11-30]; R Foundation for Statistical Computing, Vienna, Austria). Results Responses were received from 32 (84%) of 38 academic institutions that participated. A total of 245 surveys were collected from 20 December 2018 to 27 September 2019. The mean (standard deviation (SD)) percentage of correct knowledge answers in the cohort was 43.3% (22.6%). Knowledge scores were associated with obstetric anesthesia fellowship training, regularly working with infants, and current neonatal resuscitation program (NRP) training. The mean (SD) sum of comfort ratings from the individual questions was 49.9 (17.9). Comfort ratings were associated with pediatric anesthesia fellowship training, regularly working with infants, current NRP training, and having at least one year of general pediatrics residency training. Conclusions Obstetric anesthesiologists have the knowledge but appear to lack the comfort to perform neonatal resuscitation. As obstetric anesthesiologists are sometimes involved in neonatal resuscitation, maintenance of certification is important in maintaining comfort with neonatal resuscitation if not regularly working with infants.

Neonatal Resuscitation Training and Systems Strengthening to Reach the Sustainable Development Goals.

* Abbreviations: HBB — : Helping Babies Breathe HRH — : human resources for health LMICs — : low-income and lower-middle–income countries QI — : quality improvement SDG — : Sustainable Development Goal WHO — : World Health Organization On the eve of the 10th anniversary of Helping Babies Breathe (HBB), we are clearly on the precipice of a new era. Currently, the coronavirus disease 2019 pandemic has made in-person gatherings challenging, if not impossible. Health systems are stretched far beyond the typical limits. We see innovation in infection control approaches, personal protective equipment, and communication with health care professionals and families. Crisis can be the stimulus for innovation, and this will surely spur a new approach to preparation of health care workers. This preparation will go far beyond traditional concepts of training and is best conceptualized as supporting the success of health care workers as measured by their impact within a health system on the population it serves. After all, if the health of a population is not supported or improving, the health care worker is not achieving his or her goal. HBB was launched in 2010 during the Millennium Development Goals era, in which the world set 8 measurable goals that ranged from halving extreme poverty and hunger to reducing child mortality by the target date of 2015. At this time, there was a critical need to develop training materials that could be used at a local level in resource-limited settings without relying on sophisticated technology. HBB materials are available for free online and are easily downloadable so that they can be used by those with intermittent Internet access. Hard copies of the materials can be purchased or printed locally in-country. Countless labor and delivery units have the action plan hanging on the wall near the site of resuscitation, and thousands of flip charts for training … Address correspondence to Janna Patterson, MD, MPH, Global Child Health and Life Support, American Academy of Pediatrics, 345 Park Blvd, Itasca, IL 60613. E-mail: jpatterson{at}aap.org

Innovations in Cardiorespiratory Monitoring to Improve Resuscitation With Helping Babies Breathe.

Ninety percent of intrapartum-related neonatal deaths are attributable to respiratory depression, with the vast majority of these deaths occurring in low- and lower-middle-income countries. Neonatal resuscitation training with Helping Babies Breathe (HBB) decreases mortality from respiratory depression. Cardiorespiratory monitoring in conjunction with HBB can provide valuable resuscitation feedback for both training and bedside purposes. In this article, we discuss 3 innovations that couple cardiorespiratory monitoring with HBB: NeoNatalie Live, the Augmented Infant Resuscitator, and NeoBeat. NeoNatalie Live is a high-fidelity manikin that facilitates bag mask ventilation training through case scenarios of varying difficulty. The Augmented Infant Resuscitator is added in-line between a face mask and ventilation bag during bag mask ventilation training to provide users with real-time feedback on ventilation quality. NeoBeat is a battery-operated heart rate meter that digitally displays the newborn heart rate during bedside resuscitations. For each innovation, we review details of the device, implementation in the field, and areas for further research. Using early experience implementing these devices, we suggest building blocks for effective translation of training into improved care. We also highlight general challenges in implementation of devices in facilities in low- and lower-middle-income countries including considerations for training, adaptations to existing workflow, and integration into the ecosystem. Although the devices highlighted in this article hold promise, more data are needed to understand their impact on newborn outcomes.

Development of self-skill training and e-learning system for neonatal resuscitation

Purpose of the study: The Japanese Society of Perinatal and Neonatal Medicine established the Neonatal Cardio-Pulmonary Resuscitation (NCPR) training course for perinatal medical staff in 2007. Since it is difficult to maintain and improve resuscitation skills and knowledge, we considered using a self-training system to learn in low-dose and high-frequency. We have developed a self-training system to keep their skills and knowledge of neonatal resuscitation.

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.