Structured on-the-job training to improve retention of newborn resuscitation skills: a national cohort Helping Babies Breathe study in Tanzania
Structured on-the-job training to improve retention of newborn resuscitation skills: a national cohort Helping Babies Breathe study in Tanzania
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DOI：
10.1186/s12887-019-1419-5
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发表时间：
2019-02-07
期刊：
影响因子：
2.4
通讯作者：
Nelson, Brett D.
中科院分区：
文献类型：
--
作者：
Drake, Mary;Bishanga, Dunstan R.;Nelson, Brett D.
新生儿窒息是新生儿死亡的主要原因，新生儿复苏是对新生儿窒息的一种挽救生命的干预措施。提高提供者的新生儿复苏技能对于提供优质护理至关重要，但保留这些技能一直是一个挑战。坦桑尼亚利用帮助婴儿呼吸培训方案实施了一项全国新生儿复苏计划，以帮助解决这一问题。我们的目标是评估两种培训方法的有效性，新生儿复苏技能的保留在16个regions of Tanzania.MethodsAn初步培训方法实施包括口头指示参与供应商复制培训回到他们的服务提供网站，其他人谁没有受过培训。在技能明显下降之后，该方案制定了结构化的在职培训指导，并将其纳入培训。这些方法在8个地区相继实施，每个地区的护士/助产士、其他临床医生和医务人员以前都没有接受过六溴代二苯培训。新生儿复苏技能培训后立即进行评估，4- 6周后，培训使用一个有效的客观结构化的临床检查，并保留，通过程度的技能下降，进行了比较，两个培训proposities.ResultsEight，391供应商进行了培训和评估：3592进行了初步的培训方法和4799进行了修改的方法。培训后即刻，初始培训组和改良培训组的平均技能评分相似：分别为80.5%和81.3%（p值0.07）。随着时间的推移，两组新生儿复苏技能都出现了统计学显著下降。然而，改进的培训方法与培训后4- 6周的技能得分显著较高相关：改进的培训方法中的77.6%与初始培训方法中的70.7%（p值
BackgroundNewborn resuscitation is a life-saving intervention for birth asphyxia, a leading cause of neonatal mortality. Improving provider newborn resuscitation skills is critical for delivering quality care, but the retention of these skills has been a challenge. Tanzania implemented a national newborn resuscitation using the Helping Babies Breathe (HBB) training program to help address this problem. Our objective was to evaluate the effectiveness of two training approaches to newborn resuscitation skills retention implemented across 16 regions of Tanzania.MethodsAn initial training approach implemented included verbal instructions for participating providers to replicate the training back at their service delivery site to others who were not trained. After a noted drop in skills, the program developed structured on-the-job training guidance and included this in the training. The approaches were implemented sequentially in 8 regions each with nurses/ midwives, other clinicians and medical attendants who had not received HBB training before. Newborn resuscitation skills were assessed immediately after training and 4-6weeks after training using a validated objective structured clinical examination, and retention, measured through degree of skills drop, was compared between the two training approaches.ResultsEight thousand, three hundred and ninety-one providers were trained and assessed: 3592 underwent the initial training approach and 4799 underwent the modified approach. Immediately post-training, average skills scores were similar between initial and modified training groups: 80.5 and 81.3%, respectively (p-value 0.07). Both groups experienced statistically significant drops in newborn resuscitation skills over time. However, the modified training approach was associated with significantly higher skills scores 4-6weeks post training: 77.6% among the modified training approach versus 70.7% among the initial training approach (p-value