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Neonatal Resuscitation Training

Kahabi Ganka Isangula, Megan E Kassick, Allan Kaijunga Kairuki, Robson Amunga Meda, Erica Thomas, Akwila Temu, Georgina Msemo, Mary Azayo, Brett D Nelson
OBJECTIVES: Worldwide, there has been renewed emphasis on reducing neonatal mortality in low-resource countries. The Helping Babies Breathe (HBB) programme has been shown to reduce newborn deaths. The aim of this study is to present provider-level perceptions and experiences of the HBB programme implemented at-scale in Tanzania and identify key lessons learned for scalability in similar and other settings. METHODS: Focus group discussions with HBB-trained providers were conducted using a prospective longitudinal study design between October 2013 and May 2015...
September 29, 2016: Paediatrics and International Child Health
Kokui Elikplim Pomevor, Augustine Adomah-Afari
Purpose The purpose of this paper is to assess available human resources for neonatal care and their skills, in order to explore health providers' perceptions of quality of neonatal care in health facilities in Ghana. Design/methodology/approach Data were gathered using qualitative interviews with health providers working in the maternity and paediatric wards and midwives; direct observation; and documentary review at a regional hospital, a municipal hospital and four health centres in a municipality in a region in Southern Ghana...
October 10, 2016: International Journal of Health Care Quality Assurance
Nicolas J Pejovic, Daniele Trevisanuto, Jolly J Nankunda, Thorkild Tylleskär
AIM: We compared the performance of personnel in a low-resource setting when they used the I-gel cuffless neonatal laryngeal mask or a face mask on a neonatal airway management manikin. METHODS: At Mulago Hospital, Uganda, 25 doctors, nurses and midwives involved in neonatal resuscitation were given brief training with the I-gel and face mask. Then, every participant was observed positioning both devices on three consecutive occasions. The success rate and insertion times leading to effective positive pressure ventilation (PPV) were recorded...
September 1, 2016: Acta Paediatrica
Monica Thallinger, Hege Langli Ersdal, Colin Morley, Carolyn Purington, Øystein Gomo, Estomih Mduma, Joar Eilevstjønn, Ketil Størdal
OBJECTIVE: Positive end expiratory pressure (PEEP) is beneficial when ventilating preterm newborns. The aim was to study whether inexperienced providers were able to generate PEEP during simulated neonatal ventilation, using two novel prototype PEEP valves, on a self-inflating bag without an external gas source. DESIGN: Forty-six nursing students in Tanzania were trained in ventilation with a new Laerdal Upright resuscitator and mask on a NeoNatalie manikin with a newborn resuscitation monitor...
August 29, 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
Brownsyne Tucker Edmonds, Fatima McKenzie, Janet E Panoch, Douglas B White, Amber E Barnato
BACKGROUND: Relatively little is known about neonatologists' roles in helping families navigate the difficult decision to attempt or withhold resuscitation for a neonate delivering at the threshold of viability. Therefore, we aimed to describe the "decision-making role" of neonatologists in simulated periviable counseling sessions. METHODS: We conducted a qualitative content analysis of audio-recorded simulation encounters and post-encounter debriefing interviews collected as part of a single-center simulation study of neonatologists' resuscitation counseling practices in the face of ruptured membranes at 23 weeks gestation...
July 2016: AJOB Empirical Bioethics
Daniele Trevisanuto, Francesco Cavallin, Gaston Arnolda, Tran Dinh Chien, Ornella Lincetto, Ngo Minh Xuan, Nguyen Viet Tien, Nguyen Thi Xuan Hoi, Luciano Moccia
BACKGROUND: Interventions to improve neonatal resuscitation are considered a priority for reducing neonatal mortality. In addition to training programs for health caregivers, the availability of adequate equipment in all delivery settings is crucial. In this study, we assessed the availability of equipment for neonatal resuscitation in a large sample of delivery rooms in Vietnam, exploring regional differences. METHODS: In 2012, a structured questionnaire on 2011 neonatal resuscitation practice was sent to the heads of 187 health facilities, representing the three levels of hospital-based maternity services in eight administrative regions in Vietnam, allowing national and regional estimates to be calculated...
2016: BMC Pediatrics
Roopa M Bellad, Akash Bang, Waldemar A Carlo, Elizabeth M McClure, Sreelatha Meleth, Norman Goco, Shivaprasad S Goudar, Richard J Derman, Patricia L Hibberd, Archana Patel, Fabian Esamai, Sherri Bucher, Peter Gisore, Linda L Wright
BACKGROUND: Whether facility-based implementation of Helping Babies Breathe (HBB) reduces neonatal mortality at a population level in low and middle income countries (LMIC) has not been studied. Therefore, we evaluated HBB implementation in this context where our study team has ongoing prospective outcome data on all pregnancies regardless of place of delivery. METHODS: We compared outcomes of birth cohorts in three sites in India and Kenya pre-post implementation of a facility-based intervention, using a prospective, population-based registry in 52 geographic clusters...
2016: BMC Pregnancy and Childbirth
Sara K Berkelhamer, Beena D Kamath-Rayne, Susan Niermeyer
Almost one quarter of newborn deaths are attributed to birth asphyxia. Systematic implementation of newborn resuscitation programs has the potential to avert many of these deaths as basic resuscitative measures alone can reduce neonatal mortality. Simplified resuscitation training provided through Helping Babies Breathe decreases early neonatal mortality and stillbirth. However, challenges remain in providing every newborn the needed care at birth. Barriers include ineffective educational systems and programming; inadequate equipment, personnel and data monitoring; and limited political and social support to improve care...
September 2016: Clinics in Perinatology
Christiane Skåre, Anne-Marthe Boldingh, Britt Nakstad, Tor Einar Calisch, Dana E Niles, Vinay M Nadkarni, Jo Kramer-Johansen, Theresa M Olasveengen
AIM: Approximately 5% of newborns receive positive pressure ventilation (PPV) for successful transition. Guidelines urge providers to ensure effective PPV for 30-60s before considering chest compressions and intravenous therapy. Pauses in this initial PPV may delay recovery of spontaneous respiration. The aim was to find the ventilation fraction during the first 30s of PPV in non-breathing babies. METHODS: Prospective observational study in two hospitals in Norway...
October 2016: Resuscitation
Jeanette Zaichkin, Linda Mccarney, Gary Weiner
The seventh edition of the American Academy of Pediatrics/American Heart Association Neonatal Resuscitation Program (NRP) materials must be in use by January 1, 2017. As in previous editions, changes in resuscitation science are based on an international review and consensus of current resuscitation science. The seventh edition NRP materials also include enhancements to training materials aimed at improving the quality of NRP instruction and providing the opportunity for ongoing education. A standardized approach to instructor training, an online Instructor Toolkit, eSim cases, and a new learning management system are among the new resources...
2016: Neonatal Network: NN
Tetsuya Kunikata, Kayo Morita, Hayato Sakurai, Hiroko Kakei, Masakazu Honda, Masaki Wada, Hidenori Kawasaki, Masanori Tamura
BACKGROUND: The International Liaison Committee on Resuscitation (ILCOR) published Consensus 2015 in October, 2015. Thereafter, Japanese version of neonatal cardiopulmonary resuscitation programs was revised. Prior to the revision, we re-conducted questionnaire surveys in three types of medical facilities in January 2015. METHODS: Targeted groups included (1) 277 training hospitals authorized by the Japanese Society of Perinatal/Neonatal Medicine for training of physicians specialized in perinatal care (neonatology) in January 2015 (training hospitals, response rate: 70...
July 12, 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
Jonathan Reisman, Lauren Arlington, Lloyd Jensen, Henry Louis, Daniela Suarez-Rebling, Brett D Nelson
CONTEXT: Birth asphyxia contributes substantially to neonatal mortality in low- and middle-income countries (LMICs). The effects of training birth attendants in neonatal resuscitation (NR) on mortality are limited by falloff of skills and knowledge over time and transference of learned skills into clinical practice. OBJECTIVE: This review examined acquisition and retention of NR knowledge and skills by birth attendants in LMICs and the effectiveness of interventions to improve them...
August 2016: Pediatrics
K H Dellimore, C Scheffer, J Smith, D J Van Den Heever, D L Lloyd
OBJECTIVES: To investigate the influence of ventilation and ventilation-compression synchronization on compression force and sternal displacement during simulated neonatal cardiopulmonary resuscitation (NCPR) on an infant manikin. METHODS: Five Neonatal Resuscitation Program trained clinicians were recruited to perform simulated NCPR on an infant manikin using Two-Finger (TF) and Two-Thumb (TT) compression, with synchronous and asynchronous ventilation, as well as without ventilation...
July 6, 2016: Journal of Maternal-fetal & Neonatal Medicine
Carlien Van Heerden, Carin Maree, Elsie S Janse van Rensburg
BACKGROUND: Many neonatal deaths can be prevented globally through effective resuscitation. South Africa (SA) committed towards attaining the Millennium Development Goal 4 (MDG4) set by the World Health Organization (WHO). However, SA's district hospitals have the highest early neonatal mortality rates. Modifiable and avoidable causes associated with patient-related, administrative and health care provider factors contribute to neonatal mortality. A quality improvement initiative in neonatal resuscitation could contribute towards decreasing neonatal mortality, thereby contributing towards the attainment of the MDG4...
2016: African Journal of Primary Health Care & Family Medicine
Stine Lund, Ida Marie Boas, Tariku Bedesa, Wondewossen Fekede, Henriette Svarre Nielsen, Bjarke Lund Sørensen
IMPORTANCE: Health apps in low-income countries are emerging tools with the potential to improve quality of health care services, but few apps undergo rigorous scientific evaluation. OBJECTIVE: To determine the effects of the safe delivery app (SDA) on perinatal survival and on health care workers' knowledge and skills in neonatal resuscitation. DESIGN, SETTING, AND PARTICIPANTS: In a cluster-randomized clinical trial in 5 rural districts of Ethiopia, 73 health care facilities were randomized to the mobile phone intervention or to standard care (control)...
August 1, 2016: JAMA Pediatrics
Bakar Fakih, Azzah A S Nofly, Ali O Ali, Abdallah Mkopi, Ali Hassan, Ali M Ali, Kate Ramsey, Theopista John Kabuteni, Godfrey Mbaruku, Mwifadhi Mrisho
BACKGROUND: It is estimated that 287,000 women worldwide die annually from pregnancy and childbirth-related conditions, and 6.9 million under-five children die each year, of which about 3 million are newborns. Most of these deaths occur in sub-Saharan Africa. The maternal health situation in Tanzania mainland and Zanzibar is similar to other sub-Saharan countries. This study assessed the availability, accessibility and quality of emergency obstetric care services and essential resources available for maternal and child health services in Zanzibar...
2016: BMC Pregnancy and Childbirth
Ashish Kc, Johan Wrammert, Robert B Clark, Uwe Ewald, Ravi Vitrakoti, Pushpa Chaudhary, Asha Pun, Hendrikus Raaijmakers, Mats Målqvist
BACKGROUND AND OBJECTIVE: Newborns are at the highest risk of dying around the time of birth, due to intrapartum-related complications. Our study's objective was to improve adherence to the Helping Babies Breathe (HBB) neonatal resuscitation protocol and reduce perinatal mortality by using a quality improvement cycle (QIC) in a tertiary hospital in Nepal. METHODS: The HBB QIC was implemented through a multifaceted approach, including the formation of quality improvement teams; development of quality improvement goals, objectives, and standards; HBB protocol training; weekly review meetings; daily skill checks; use of self-evaluation checklists; and refresher training...
June 2016: Pediatrics
Mohan Pammi, Eugene M Dempsey, C Anthony Ryan, Keith J Barrington
BACKGROUND: Substantial health care resources are expended on standardised formal neonatal resuscitation training (SFNRT) programmes, but their effectiveness has not been proven. OBJECTIVES: To determine whether SFNRT programmes reduce neonatal mortality and morbidity, improve acquisition and retention of knowledge and skills, or change teamwork and resuscitation behaviour. METHODS: We searched CENTRAL, MEDLINE, PREMEDLINE, EMBASE, CINAHL, Web of Science and the Oxford Database of Perinatal Trials, ongoing trials and conference proceedings in April 2015, and included randomised or quasi-randomised trials that reported at least one of our specified outcomes...
2016: Neonatology
Amy J Jnah, Desi M Newberry, Andrea N Trembath, Tracey Robertson, April Downing, Miriam Greene, Kerry Sewell
BACKGROUND: The Neonatal Resuscitation Program's (NRP's) Sixth Edition introduced simulation-based training (SBT) into neonatal life support training. SBT offers neonatal emergency response teams a safe, secure environment to rehearse coordinated neonatal resuscitations. Teamwork and communication training can reduce tension and anxiety during neonatal medical emergencies. PURPOSE: To discuss the implications of variability in number and type of simulation scenario, number and type of learners who comprise a course, and their influence upon scope of practice, role confusion, and role ambiguity...
June 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
Dilek Dilli, M Rıfat Köse, R Coşkun Gündüz, Sema Özbaş, Başak Tezel, Nurullah Okumuş
BACKGROUND: Infant mortality rate (IMR) and neonatal mortality rate (NMR) are accepted as good indicators to measure the health status of a nation. This report describes recent declines in IMR and NMR in Turkey. METHODS: Data on infants who died before 12 months of life were obtained from the Infant Mortality Monitoring System of Ministry of Health of Turkey between 2007 and 2012. A total of 94,038 infant deaths were evaluated. RESULTS: Turkey IMR and NMR exhibited a marked decline from 2007 (16...
March 2016: Central European Journal of Public Health
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