The impact of the Helping Babies Survive program on neonatal outcomes and health provider skills: a systematic review.
The impact of the Helping Babies Survive program on neonatal outcomes and health provider skills: a systematic review.
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DOI：
10.11124/jbisrir-2017-003535
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发表时间：
2018-03-01
期刊：
影响因子：
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通讯作者：
Richardson, Brianna
中科院分区：
文献类型：
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作者：
Dol, Justine;Campbell-Yeo, Marsha;Richardson, Brianna
目的：评价帮助婴儿存活计划对新生儿结局和保健提供者知识和技能的影响。结论：帮助婴儿存活计划包括三个模块：帮助婴儿呼吸、为每个婴儿提供基本护理和为小婴儿提供基本护理。它的开发是为了通过使用模拟、学习练习和对低资源地区的医疗保健提供者进行点对点培训的基于技能的学习来减少可预防的新生儿死亡。尽管通过帮助婴儿存活而进行的医疗保健提供者培训得到了广泛的增加，而且进行的研究也越来越多，但到目前为止，还没有对帮助婴儿生存计划进行系统审查。结论：审查包括关于医疗保健提供者和/或助产士在出生期间和产后提供基本新生儿护理的研究。干预的类型是任何帮助婴儿生存的模块(帮助婴儿呼吸、每个婴儿的基本护理、小婴儿的基本护理)。研究包括实验研究设计，结果如下：新生儿结局和/或医疗保健提供者的知识和技能随着时间的推移获得、维护和使用。方法：检索PubMed、Embase、Web of Science、ProQuest数据库、Scope us和CINAHL，检索2010年1月至2016年12月期间发表的研究。批判性评价由两名独立审查员使用乔安娜·布里格斯研究所(JBI)的标准化批判性评价工具进行。冲突通过与第三个审查者的协商一致得到解决。定量数据由两名评价者使用JBI的标准化数据提取工具独立地从纳入的研究中提取。冲突通过与第三个审查者的协商一致得到解决。在可能的情况下，使用Revman(哥本哈根：北欧Cochrane中心，Cochrane)将定量数据汇集在统计荟萃分析中。结果：总共确定了17项研究-15项关于帮助婴儿呼吸的研究(n = 172,685名婴儿和n = 2,261名医疗保健提供者)和2项关于每个婴儿的基本护理(n = 206名医疗保健提供者)。没有关于小婴儿基本护理的研究报告。研究发现，帮助婴儿存活可以显著降低新鲜死产率和第一天死亡率，但没有发现影响出生后7天或28天的死产率或死亡率。短期的改善在知识和技能得分上是显著的，但随着时间的推移在可持续性方面并不显著。此外，在临床实践中实施与帮助婴儿呼吸模块相关的复苏技能，包括干燥/刺激、抽吸、袋式和面罩通风，培训后未显示出明显增加，尽管新鲜死产数量和首日死亡率有所下降。结论：帮助婴儿存活对早期新生儿结局有显著的积极影响，包括主要通过帮助婴儿呼吸，但其对其他新生儿结局的影响结论有限。虽然研究发现，帮助婴儿存活可以提高即刻的知识和技能获得，但有一些证据表明，一次性培训可能不足以获得持续的知识，也不足以将与复苏相关的关键技能纳入临床实践。需要对持续的知识和技能进行持续研究，以评估帮助婴儿存活计划的长期影响。
OBJECTIVE: The objective of this review was to evaluate the impact of the Helping Babies Survive program on neonatal outcomes and healthcare provider knowledge and skills.INTRODUCTION: The Helping Babies Survive program consists of three modules: Helping Babies Breathe, Essential Care for Every Baby, and Essential Care for Small Babies. It was developed to reduce preventable newborn deaths through skill-based learning using simulation, learning exercises, and peer-to-peer training of healthcare providers in low-resource areas. Despite the widespread increase in healthcare provider training through Helping Babies Survive and the growing number of studies that have been conducted, there has been no systematic review of the Helping Babies Survive program to date.INCLUSION CRITERIA: The review included studies on healthcare providers and/or birth attendants providing essential neonatal care during and post birth. Types of interventions were any Helping Babies Survive module (Helping Babies Breathe, Essential Care for Every Baby, Essential Care for Small Babies). Studies including experimental study designs with the following outcomes were considered: neonatal outcomes and/or healthcare provider knowledge and skills obtained, maintained, and used over time.METHODS: PubMed, Embase, Web of Science, ProQuest Databases, Scopus and CINAHL were searched for published studies in English between January 2010 to December 2016. Critical appraisal was undertaken by two independent reviewers using standardized critical appraisal instruments from the Joanna Briggs Institute (JBI). Conflicts were solved through consensus with a third reviewer. Quantitative data were extracted from included studies independently by two reviewers using the standardized data extraction tool from JBI. Conflicts were solved through consensus with a third reviewer. Quantitative data was, where possible, pooled in statistical meta-analysis using RevMan (Copenhagen: The Nordic Cochrane Centre, Cochrane). Where statistical pooling was not possible the findings have been reported narratively.RESULTS: A total of 17 studies were identified - 15 on Helping Babies Breathe (n = 172,685 infants and n = 2,261 healthcare providers) and two on Essential Care for Every Baby (n = 206 healthcare providers). No studies reported on Essential Care for Small Babies. Helping Babies Survive was found to significantly reduce fresh stillbirth rates and first day mortality rates, but was not found to influence stillbirth rates or mortality rates, measured at seven or 28 days post birth. Short-term improvements were significant in knowledge and skills scores but not significant in sustainability over time. Additionally, implementation of resuscitations skills in clinical practice related to the Helping Babies Breathe module including drying/stimulation, suction, and bag and mask ventilation did not show a significant increase after training even though the number of fresh stillbirth and first-day mortality rate decreased.CONCLUSIONS: Helping Babies Survive has a significant positive impact on early neonatal outcomes, including fresh stillbirth and first-day mortality primarily through Helping Babies Breathe, but limited conclusions can be drawn about its impact on other neonatal outcomes. While Helping Babies Survive was found to improve immediate knowledge and skill acquisition, there is some evidence that one-time training may not be sufficient for sustained knowledge or the incorporation of key skills related to resuscitation into clinical practice. Continued research on the sustained knowledge and skills is needed to evaluate the long-term impact of the Helping Babies Survive program.