Effect of a Neonatal Resuscitation Course on Healthcare Providers' Performances Assessed by Video Recording in a Low-Resource Setting.
Effect of a Neonatal Resuscitation Course on Healthcare Providers' Performances Assessed by Video Recording in a Low-Resource Setting.
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DOI：
10.1371/journal.pone.0144443
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Putoto G
中科院分区：
文献类型：
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作者：
Trevisanuto D;Bertuola F;Lanzoni P;Cavallin F;Matediana E;Manzungu OW;Gomez E;Da Dalt L;Putoto G
我们通过使用录像评估了适应性新生儿复苏计划（NRP）课程对医疗保健提供者在低资源环境中的表现的影响。在莫桑比克贝拉中心医院的产房里，一台安装在辐射加热器上的录像机被用来记录所有的复苏。收集了100例复苏（参与适应性NRP课程前50例，参与适应性NRP课程后50例），并根据先前公布的评分进行评估。所有100名新生儿接受初始步骤，其中77名和32名分别需要袋式面罩通气（BMV）和胸外按压（CC）。从课程前到课程后，所有级别复苏的复苏评分均有显著改善：对于“初始步骤”，评分从33%增加到33%，对于BMV，从20%（20-40）到40%（40-60），p = 0.001;对于CC，从0%（0-10）到20%（0-50），p = 0.01。与课程前相比，课程后的复苏干预时间有所改善，但仍不符合推荐的算法。虽然复苏仍然低于建议的标准，在执行的质量和时间，医疗服务提供者的临床实践改善后，参加了适应NRP课程。录像被工作人员广泛接受，有助于客观评估复苏过程中的表现，并可用作低资源环境中的教育工具。
We assessed the effect of an adapted neonatal resuscitation program (NRP) course on healthcare providers’ performances in a low-resource setting through the use of video recording. A video recorder, mounted to the radiant warmers in the delivery rooms at Beira Central Hospital, Mozambique, was used to record all resuscitations. One-hundred resuscitations (50 before and 50 after participation in an adapted NRP course) were collected and assessed based on a previously published score. All 100 neonates received initial steps; from these, 77 and 32 needed bag-mask ventilation (BMV) and chest compressions (CC), respectively. There was a significant improvement in resuscitation scores in all levels of resuscitation from before to after the course: for “initial steps”, the score increased from 33% (IQR 28–39) to 44% (IQR 39–56), p<0.0001; for BMV, from 20% (20–40) to 40% (40–60), p = 0.001; and for CC, from 0% (0–10) to 20% (0–50), p = 0.01. Times of resuscitative interventions after the course were improved in comparison to those obtained before the course, but remained non-compliant with the recommended algorithm. Although resuscitations remained below the recommended standards in terms of quality and time of execution, clinical practice of healthcare providers improved after participation in an adapted NRP course. Video recording was well-accepted by the staff, useful for objective assessment of performance during resuscitation, and can be used as an educational tool in a low-resource setting.