scholarly journals Training and evaluating simulation debriefers in low-resource settings: lessons learned from Bihar, India

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Julia H. Raney ◽  
Melissa M. Medvedev ◽  
Susanna R. Cohen ◽  
Hilary Spindler ◽  
Rakesh Ghosh ◽  
...  
Keyword(s):  
Learning Environment ◽  
Interrater Reliability ◽  
Simulation Training ◽  
Lessons Learned ◽  
Video Data ◽  
Low Resource Settings ◽  
Low Resource ◽  
Simulation Based ◽  
Safe Learning Environment ◽  
Over Time

Abstract Background To develop effective and sustainable simulation training programs in low-resource settings, it is critical that facilitators are thoroughly trained in debriefing, a critical component of simulation learning. However, large knowledge gaps exist regarding the best way to train and evaluate debrief facilitators in low-resource settings. Methods Using a mixed methods approach, this study explored the feasibility of evaluating the debriefing skills of nurse mentors in Bihar, India. Videos of obstetric and neonatal post-simulation debriefs were assessed using two known tools: the Center for Advanced Pediatric and Perinatal Education (CAPE) tool and Debriefing Assessment for Simulation in Healthcare (DASH). Video data was used to evaluate interrater reliability and changes in debriefing performance over time. Additionally, twenty semi-structured interviews with nurse mentors explored perceived barriers and enablers of debriefing in Bihar. Results A total of 73 debriefing videos, averaging 18 min each, were analyzed by two raters. The CAPE tool demonstrated higher interrater reliability than the DASH; 13 of 16 CAPE indicators and two of six DASH indicators were judged reliable (ICC > 0.6 or kappa > 0.40). All indicators remained stable or improved over time. The number of ‘instructors questions,’ the amount of ‘trainee responses,’ and the ability to ‘organize the debrief’ improved significantly over time (p < 0.01, p < 0.01, p = 0.04). Barriers included fear of making mistakes, time constraints, and technical challenges. Enablers included creating a safe learning environment, using contextually appropriate debriefing strategies, and team building. Overall, nurse mentors believed that debriefing was a vital aspect of simulation-based training. Conclusion Simulation debriefing and evaluation was feasible among nurse mentors in Bihar. Results demonstrated that the CAPE demonstrated higher interrater reliability than the DASH and that nurse mentors were able to maintain or improve their debriefing skills overtime. Further, debriefing was considered to be critical to the success of the simulation training. However, fear of making mistakes and logistical challenges must be addressed to maximize learning. Teamwork, adaptability, and building a safe learning environment enhanced the quality enhanced the quality of simulation-based training, which could ultimately help to improve maternal and neonatal health outcomes in Bihar.

scholarly journals Challenging the barriers to accessing surgery in low-resource settings: Lessons learned from burns

Surgery ◽  
2015 ◽  
Vol 158 (1) ◽  
pp. 33-36 ◽  
Author(s):  
Greg Elder ◽  
Richard A. Murphy ◽  
Patrick Herard ◽  
Kelly Dilworth ◽  
David Olson ◽  
...  
Keyword(s):  
Lessons Learned ◽  
Low Resource Settings ◽  
Low Resource

scholarly journals Applying Lessons Learned From Low-Resource Settings to Prioritize Cancer Care in a Pandemic

JAMA Oncology ◽  
2020 ◽  
Vol 6 (9) ◽  
pp. 1429
Author(s):  
Rebecca J. DeBoer ◽  
Temidayo A. Fadelu ◽  
Lawrence N. Shulman ◽  
Katherine Van Loon
Keyword(s):  
Cancer Care ◽  
Lessons Learned ◽  
Low Resource Settings ◽  
Low Resource

scholarly journals Success criteria for electronic medical record implementations in low-resource settings: a systematic review

2015 ◽  
Vol 22 (2) ◽  
pp. 479-488 ◽  
Author(s):  
Fleur Fritz ◽  
Binyam Tilahun ◽  
Martin Dugas
Keyword(s):  
Medical Record ◽  
Electronic Medical Record ◽  
Reliable Data ◽  
Lessons Learned ◽  
African Countries ◽  
Low Resource Settings ◽  
Low Resource ◽  
Use Of Resources ◽  
Success Criteria ◽  
The Right

Abstract Objective Electronic medical record (EMR) systems have the potential of supporting clinical work by providing the right information at the right time to the right people and thus make efficient use of resources. This is especially important in low-resource settings where reliable data are also needed to support public health and local supporting organizations. In this systematic literature review, our objectives are to identify and collect literature about success criteria of EMR implementations in low-resource settings and to summarize them into recommendations. Materials and Methods Our search strategy relied on PubMed queries and manual bibliography reviews. Studies were included if EMR implementations in low-resource settings were described. The extracted success criteria and measurements were summarized into 7 categories: ethical, financial, functionality, organizational, political, technical, and training. Results We collected 381 success criteria with 229 measurements from 47 articles out of 223 articles. Most papers were evaluations or lessons learned from African countries, published from 1999 to 2013. Almost half of the EMR systems served a specific disease area like human immunodeficiency virus (HIV). The majority of criteria that were reported dealt with the functionality, followed by organizational issues, and technical infrastructures. Sufficient training and skilled personnel were mentioned in roughly 10%. Political, ethical, and financial considerations did not play a predominant role. More evaluations based on reliable frameworks are needed. Conclusions Highly reliable data handling methods, human resources and effective project management, as well as technical architecture and infrastructure are all key factors for successful EMR implementation.

scholarly journals Recent experiences and lessons learned in vasectomy programming in low-resource settings: A document review

2016 ◽  
Keyword(s):  
Family Planning ◽  
Service Providers ◽  
Unmet Need ◽  
Cost Effective ◽  
Lessons Learned ◽  
Low Resource Settings ◽  
Low Resource ◽  
Unintended Pregnancies ◽  
National Family Planning ◽  
Document Review

Vasectomy is a safe and highly effective family planning method for men and couples who do not want any more children, but in low resource settings, few men seek out or have access to this method. Increasing the voluntary use of vasectomy is a cost-effective strategy for countries to reduce unmet need for family planning, decrease unintended pregnancies, and meet national family planning goals. By engaging men directly in family planning, vasectomy also holds promise for promoting positive gender norms and healthy relationships. | This report is part of a set of resources from FHI 360/Evidence Project providing policymakers, advocates, program managers, and service providers with evidence-based recommendations for improving vasectomy programming.

scholarly journals Helping Babies Breathe and its effects on intrapartum-related stillbirths and neonatal mortality in low-resource settings: a systematic review

2019 ◽  
pp. archdischild-2018-316319 ◽  
Author(s):  
Jorien M D Versantvoort ◽  
Mirjam Y Kleinhout ◽  
Henrietta D L Ockhuijsen ◽  
Kitty Bloemenkamp ◽  
Willem B de Vries ◽  
...  
Keyword(s):  
Systematic Review ◽  
Neonatal Mortality ◽  
Data Extraction ◽  
Neonatal Resuscitation ◽  
Eligibility Criteria ◽  
Low Resource Settings ◽  
Low Resource ◽  
Helping Babies Breathe ◽  
Simulation Based ◽  
Registration Number

BackgroundAn important factor in worldwide neonatal mortality is the deficiency in neonatal resuscitation skills among trained professionals. ‘Helping Babies Breathe’ (HBB) is a simulation-based training course designed to train healthcare professionals in the initial steps of neonatal resuscitation in low-resource areas. The aim of this systematic review is to provide an overview of the available evidence regarding intrapartum-related stillbirths and neonatal mortality related to the HBB training and resuscitation method.Data sourcesCochrane, CINAHL, Embase, PubMed and Scopus.Study eligibility criteriaConducted in low-resource settings focusing on the effects of HBB on intrapartum-related stillbirths and neonatal mortality.Study appraisalIncluded studies were reviewed independently by two researchers in terms of methodological quality.Data extractionData were extracted by two independent reviewers and crosschecked by one additional reviewer.ResultsSeven studies were included in this systematic review; the selected studies included a total of 230.797 neonates. Significant decreases were found after the implementation of HBB in one of two studies describing perinatal mortality (n=25 108, rate ratio (RR) 0.75; p<0.001), four out of six studies related to intrapartum-related stillbirths (n=125.720, RR 0.31–0.76), in four out of five studies focusing on 1 day neonatal mortality (n=111.289, RR 0.37–0.67), and one out of three studies regarding 7 day neonatal mortality (n=4.390, RR 0.32). No changes were seen in late neonatal mortality after HBB training and resuscitation method.LimitationsIncluded studies in were predominantly of moderate quality, therefore no strong recommendations can be made.Conclusions and implications of key findingsDue to the heterogeneous quality of the studies, this systematic review showed moderate evidence for a decrease in intrapartum-related stillbirth and 1-day neonatal mortality rate after implementing the ‘Helping Babies Breathe’ training and resuscitation method. Further research is required to address the effects of simulation-based team training on morbidity and mortality beyond the initial neonatal period.PROSPERO registration numberCRD42018081141.

Diagnosis of neonatal sepsis in low resource settings: C-reactive protein or procalcitonin?

2016 ◽  
Vol 03 (02) ◽  
pp. 079-083
Author(s):  
Lawrence Mbuagbaw ◽  
Francisca Monebenimp ◽  
Bolaji Obadeyi ◽  
Grace Bissohong ◽  
Marie-Thérèse Obama ◽  
...  
Keyword(s):  
Neonatal Sepsis ◽  
C Reactive Protein ◽  
Low Resource Settings ◽  
Low Resource ◽  
Reactive Protein
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