scholarly journals Helping Babies Breathe (HBB) Program for Reduction of Neonatal Mortality: A Hospital Based Cost Effective Intervention in Nepal

2020 ◽  
Vol 19 (1) ◽  
pp. 48-50
Author(s):  
Kanchan Thapa ◽  
Robert B. Clark ◽  
Michael K. Visick ◽  
Yubanidhi Basaula ◽  
Rakesh Hamal ◽  
...  
Keyword(s):  
Neonatal Resuscitation ◽  
Neonatal Morbidity ◽  
Cost Effective ◽  
Effective Intervention ◽  
Helping Babies Breathe ◽  
Hospital Nursing ◽  
Resource Limited ◽  
Master Trainer ◽  
Nursing College ◽  
Limited Setting

Helping Babies Breath (HBB) is an evidence based educational curriculum practiced worldwide to teach neonatal resuscitation. It is famous and cost effective intervention in resource limited setting. In this regard, we have been implementing HBB program in Nepal through hospitals where delivery rate is higher. In this program, a pair of trainers have been trained as Master Trainer. These trainer back to hospital and train their colleagues in own facility. We have already produced more than seven hundred master trainers from hospital, nursing college, medical colleges and university in Nepal. Through the program, it aims to reduce the neonatal morbidity and mortality so that the country will achieve the target set by SDGs.

scholarly journals Teaching Helping Babies Breathe via Telehealth: A New Application in Rural Guatemala

2019 ◽  
Vol 4 (3) ◽  
pp. 1-6
Author(s):  
Caitlin Jones-Bamman ◽  
Susan Niermeyer ◽  
Kelly McConnell ◽  
John F. Thomas ◽  
Christina Olson
Keyword(s):  
Nursing Students ◽  
Neonatal Resuscitation ◽  
Cost Effective ◽  
Helping Babies Breathe ◽  
Life Saving ◽  
Percent Improvement ◽  
Hands On ◽  
Post Test ◽  
Course Material ◽  
Passing Scores

Background: Helping Babies Breathe (HBB) is a neonatal resuscitation curriculum that teaches life-saving interventions utilized in the first minutes after birth, reducing morbidity and mortality. Traditionally, it requires in-person facilitators for didactic and hands-on training. Objectives: The aim of this study was to offer HBB to nurses and nursing students in Guatemala, with the lead facilitator presenting concepts via telehealth and in-person facilitators providing hands-on demonstration. Methods: Learners completed pre- and post-tests that included the standard HBB knowledge check, as well as an assessment of the course teaching model. Learners also completed the standard Objective Structured Clinical Evaluations (OSCEs). Results: Eighteen learners were included in the analysis. All but one learner (94%) passed the course, and the average percent improvement from the pre- to post-test was 12%. All learners achieved passing scores on the OSCEs. Learners responded positively to questions regarding the technology, connection with the instructor, and ability to ask questions. Ninety-four percent of the learners agreed with the statement “this lecture was as good via telehealth as in person.” A cost analysis demonstrated approximately USD 3,979.00 in savings using telehealth compared to a standard in-person course. Conclusions: The telehealth model was successful in delivering course material to the learners and was well received. This model represents a cost-effective way to improve access to HBB. This study may not be generalizable to other populations, and the ability to use telehealth requires reliable internet connectivity, which may not be available in all settings. Further study and expansion of this pilot are needed to assess success in other settings.

scholarly journals Efficacy of pedagogical framework in neonatal resuscitation skill learning in a resource-limited setting: a randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mishal Liaqat ◽  
Muhammad Hussain ◽  
Muhammad Afzal ◽  
Maryam Altaf ◽  
Sadia Khan ◽  
...  
Keyword(s):  
Nursing Students ◽  
Controlled Trial ◽  
Neonatal Resuscitation ◽  
Technical Skills ◽  
Technical Skill ◽  
Resource Limited Setting ◽  
Skill Learning ◽  
Traditional Group ◽  
Resource Limited ◽  
Limited Setting

Abstract Background The educational efficacy in neonatal resuscitation relies on the subject and teaching strategies. Therefore, it is imperative to test diverse educational methods if they are more instructive to engage students in active learning and practicing knowledge. Hence, the present study aims to investigate the efficacy of a pedagogical framework in neonatal resuscitation skill learning among nursing students in a resource-limited setting. Methods A single-blind randomized controlled trial was conducted between October 2020 to March 2021. Sixty nursing students in the 3rd and 4th year of professional training were randomly allocated to the pedagogy and the traditional group. The pedagogy group learned via 6-step LSPPDM (Learn, See, Practice, Prove, Do, Maintain) pedagogy including lectures, video, clinical observation, skill sessions under supervision, and self-directed practice. The traditional group learned through 2-step (Learn, Practice) method that included lectures and skill sessions under supervision. The outcomes measured included technical and non-technical skills in neonatal resuscitation. The technical skill deals with steps such as stimulation, ventilation, oxygenation, intubation, chest compression, medications, and reporting. Non-technical skills refer to teamwork skills that focus on the interaction between leader and helper. Both skills were measured through previously published validated tools two times before and after the intervention by blinded assessors in a simulated delivery room. Results Overall, the skill was significantly improved in both groups after intervention. Yet, the results showed that the mean difference of technical skill score in the pedagogy group (24.3 ± 3.5) was significantly higher (p <  0.001) compared to the traditional group (16.2 ± 2.4). Likewise, the mean difference of non-technical skill score in the pedagogy (36.9 ± 1.9) was highly significant (p <  0.001) compared to the traditional group (31.2 ± 1.7). Conclusions The LSPPDM pedagogy was found more effective in enhancing technical and non-technical skills in neonatal resuscitation compared to the traditional method. The results of this study support the efficacy of the 6-step LSPPDM pedagogy in the education of nursing students regarding neonatal resuscitation in a resource-limited setting. Trial registration Prospectively registered at ClinicalTrials.gov (NCT04748341).

scholarly journals Economic Evaluation of Letrozole for Early Breast Cancer in a Health Resource-Limited Setting

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Ming Ye ◽  
Jingsong Lu ◽  
Fan Yang ◽  
Bin Wu
Keyword(s):  
Breast Cancer ◽  
Endocrine Therapy ◽  
Early Breast Cancer ◽  
Cost Effective ◽  
Resource Limited Setting ◽  
Adjuvant Endocrine Therapy ◽  
Sensitivity Analyses ◽  
Health Resource ◽  
Resource Limited ◽  
Limited Setting

Objective. Long-term aromatase inhibitor (AI) therapy is expected to improve the health outcomes with high health resource consumption in early breast cancer. The aim of the study was to assess the cost-effectiveness of letrozole for postmenopausal women with estrogen receptor positive early breast cancer in a health resource-limited setting. Methods. A Markov model was developed to project the lifetime outcomes based on the clinical course of early breast cancer. The clinical and utility data were derived from reported results. Costs were estimated from the perspective of Chinese health care. The quality-adjusted life-year (QALY) and incremental cost-effective ratio (ICER) were measured. Probabilistic sensitivity and one-way analyses were conducted. Results. Compared to 5 years of tamoxifen therapy, 5 years of AI treatment with letrozole improved the QALYs (10.44 versus 10.84) and increased the lifetime costs (CNY ¥13,613 versus CNY ¥28,797), resulting in an ICER of CNY ¥38,092 /QALY. The ICER of 5 years of letrozole versus 2–3 years of tamoxifen and then letrozole was CNY ¥68,233 /QALY. Sensitivity analyses showed that the age of initiating adjuvant endocrine therapy was the most influential parameter. Conclusions. In health resource-limited settings, adjuvant endocrine therapy with letrozole is a cost-effective strategy compared to tamoxifen in women with early breast cancer.

48-hour video-EEG monitoring for epilepsy presurgical evaluation is cost-effective and safe in resource-limited setting

2020 ◽  
Vol 162 ◽  
pp. 106298
Author(s):  
Kheng-Seang Lim ◽  
Si-Lei Fong ◽  
Minh-An Thuy Le ◽  
Sherrini Ahmad Bazir ◽  
Vairavan Narayanan ◽  
...  
Keyword(s):  
Cost Effective ◽  
Resource Limited Setting ◽  
Eeg Monitoring ◽  
Presurgical Evaluation ◽  
Resource Limited ◽  
Video Eeg ◽  
Limited Setting

scholarly journals Performance of health workers on neonatal resuscitation care following scaled-up quality improvement interventions in public hospitals of Nepal - a prospective observational study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dipak Raj Chaulagain ◽  
Mats Malqvist ◽  
Olivia Brunell ◽  
Johan Wrammert ◽  
Omkar Basnet ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Health Workers ◽  
Clinical Performance ◽  
Newborn Infants ◽  
Neonatal Resuscitation ◽  
Public Hospitals ◽  
Intervention Package ◽  
Helping Babies Breathe ◽  
Resource Limited ◽  
Before And After

Abstract Background High-quality resuscitation among non-crying babies immediately after birth can reduce intrapartum-related deaths and morbidity. Helping Babies Breathe program aims to improve performance on neonatal resuscitation care in resource-limited settings. Quality improvement (QI) interventions can sustain simulated neonatal resuscitation knowledge and skills and clinical performance. This study aimed to evaluate the effect of a scaled-up QI intervention package on the performance of health workers on basic neonatal resuscitation care among non-crying infants in public hospitals in Nepal. Methods A prospective observational cohort design was applied in four public hospitals of Nepal. Performances of health workers on basic neonatal care were analysed before and after the introduction of the QI interventions. Results Out of the total 32,524 births observed during the study period, 3031 newborn infants were not crying at birth. A lower proportion of non-crying infants were given additional stimulation during the intervention compared to control (aOR 0.18; 95% CI 0.13–0.26). The proportion of clearing the airway increased among non-crying infants after the introduction of QI interventions (aOR 1.23; 95% CI 1.03–1.46). The proportion of non-crying infants who were initiated on BMV was higher during the intervention period (aOR 1.28, 95% CI 1.04–1.57) compared to control. The cumulative median time to initiate ventilation during the intervention was 39.46 s less compared to the baseline. Conclusion QI intervention package improved health workers’ performance on the initiation of BMV, and clearing the airway. The average time to first ventilation decreased after the implementation of the package. The QI package can be scaled-up in other public hospitals in Nepal and other similar settings.

Neonatal Resuscitation Guidelines—Recent Updates and Implications

2021 ◽  
pp. 097321792110596
Author(s):  
Prathik Bandiya ◽  
Debasish Nanda ◽  
Tapas Bandyopadhyay
Keyword(s):  
American Heart ◽  
Neonatal Resuscitation ◽  
Heart Association ◽  
Clinical Implications ◽  
Evidence Based ◽  
European Resuscitation Council ◽  
Resource Limited ◽  
Resuscitation Guidelines ◽  
User Friendly ◽  
Limited Setting

Neonatal resuscitation guidelines are based on the most recent evidence-based interventions and provide recommendation for practice. The guidelines are being updated periodically to reflect the newer evidences to improve care. The guidelines continuously look forward to improve the algorithm and make it simpler and user friendly to help the clinicians learn and practice as a team. In addition to knowledge, the need of skill development and practice has been emphasized in the recent guidelines. Recently, American Heart Association and The European Resuscitation Council have updated their guidelines on neonatal resuscitation. In this update, we have summarized the recommendations from the 2 recent guidelines on neonatal resuscitation and discussed their clinical implications in resource limited setting.

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