scholarly journals Simulation-Based Education in the Training of Newborn Care Providers—A Malaysian Perspective

2021 ◽  
Vol 9 ◽  
Author(s):  
Kwai-Meng Pong ◽  
Jerrold Tze-Ren Teo ◽  
Fook-Choe Cheah
Keyword(s):  
Neonatal Intensive Care ◽  
Ad Hoc ◽  
Healthcare Providers ◽  
Neonatal Resuscitation ◽  
Newborn Care ◽  
Care Practice ◽  
Care Providers ◽  
Educator Training ◽  
Simulation Based ◽  
Set Up

Simulation-based education (SBE) is increasingly used as an education tool to improve learning for healthcare providers. In newborn care practice, SBE is used in the Neonatal Resuscitation Program (NRP) and training in procedural skills. The NRP is a mandatory course in Malaysia for all house officers (interns) and medical officers (residents) during their pediatric rotation. Almost 30,000 of NRP providers have been trained over the last 5 years. The recent establishment of the Allied Healthcare Center of Excellence (AHCoE), an organization dedicated to promoting SBE, and Malaysian Society for Simulation in Healthcare (MaSSH) aims to enhance the integration of SBE into the healthcare training curriculum and set up a local healthcare simulation educator training program. Our experience in implementing SBE necessitated that we made several important choices. As there was no strong evidence to favor high-fidelity over low-fidelity simulation, and because simulation centers can be very costly to set up with limited resources, we chose SBE mainly in the form of low-fidelity and in situ simulation. We also identified an important developmental goal to train Malaysian instructors on structured debriefing, a critical activity for learning in SBE. Currently, debriefing is often carried out in our centers at an ad hoc basis because of time limitation and the lack of personnel trained. Finally, we aim to implement SBE further in Malaysia, with two axes: (1) the credentialing and recertification of physicians and nurses, and (2) the education of lay caregivers of high-risk infants before discharge from the neonatal intensive care unit.

scholarly journals Mindset Moderates Healthcare Providers' Longitudinal Performance in a Digital Neonatal Resuscitation Simulator

2021 ◽  
Vol 8 ◽  
Author(s):  
Chang Lu ◽  
Simran K. Ghoman ◽  
Maria Cutumisu ◽  
Georg M. Schmölzer
Keyword(s):  
Healthcare Providers ◽  
Neonatal Resuscitation ◽  
Growth Mindset ◽  
Moderating Effect ◽  
Repeated Measure ◽  
Test Time ◽  
Future Research ◽  
Knowledge Gain ◽  
Resuscitation Training ◽  
Simulation Based

Background: Simulation education can benefit healthcare providers (HCPs) by providing opportunities to practice complex neonatal-resuscitation tasks in low-stake environments. To our knowledge, no study investigated the role of growth mindset on longitudinal performance on neonatal resuscitation before and after simulation-based training.Objectives: This study examines whether 1) the RETAIN digital/table-top simulators facilitate HCPs' neonatal resuscitation knowledge gain, retention, and transfer and 2) growth mindset moderates HCPs' longitudinal performance in neonatal resuscitation.Methods: Participants were n = 50 HCPs in a tertiary perinatal center in Edmonton, Canada. This longitudinal study was conducted in three stages including 1) a pretest and a mindset survey, immediately followed by a posttest using the RETAIN digital simulator from April to August 2019; 2) a 2-month delayed posttest using the same RETAIN neonatal resuscitation digital simulator from June to October 2019; and 3) a 5-month delayed posttest using the low-fidelity table-top neonatal resuscitation digital simulator from September 2019 to January 2020. Three General Linear Mixed Model (GLMM) repeated-measure analyses investigated HCPs' performance on neonatal resuscitation over time and the moderating effect of growth mindset on the association between test time points and task performance.Results: Compared with their pretest performance, HCPs effectively improved their neonatal resuscitation knowledge after the RETAIN digital simulation-based training on the immediate posttest (Est = 1.88, p < 0.05), retained their knowledge on the 2-month delayed posttest (Est = 1.36, p < 0.05), and transferred their knowledge to the table-top simulator after 5 months (Est = 2.01, p < 0.05). Although growth mindset did not moderate the performance gain from the pretest to the immediate posttest, it moderated the relationship between HCPs' pretest and long-term knowledge retention (i.e., the interaction effect of mindset and the 2-month posttest was significant: Est = 0.97, p < 0.05). The more they endorsed a growth mindset, the better the HCPs performed on the posttest, but only when they were tested after 2 months.Conclusions: Digital simulators for neonatal resuscitation training can effectively facilitate HCPs' knowledge gain, maintenance, and transfer. Besides, growth mindset shows a positive moderating effect on the longitudinal performance improvement in simulation-based training. Future research can be conducted to implement growth-mindset interventions promoting more effective delivery of technology-enhanced, simulation-based training and assessment.

Benefits of recording and reviewing neonatal resuscitation: the providers’ perspective

2018 ◽  
Vol 104 (5) ◽  
pp. F528-F534 ◽  
Author(s):  
Maria C den Boer ◽  
Mirjam Houtlosser ◽  
Elizabeth E Foglia ◽  
Ratna N G B Tan ◽  
Dirk P Engberts ◽  
...  
Keyword(s):  
Neonatal Intensive Care ◽  
Medical Center ◽  
Neonatal Resuscitation ◽  
Neonatal Care ◽  
Successful Implementation ◽  
Care Providers ◽  
Educational Benefits ◽  
Staff Members ◽  
Objective Feedback ◽  
Qualitative Data Analysis Software

ObjectiveTo assess benefits of recording and reviewing neonatal resuscitation as experienced by neonatal care providers.DesignA qualitative study using semistructured interviews questioning neonatal care providers about their experiences with recording and reviewing neonatal resuscitation. Data were analysed using the qualitative data analysis software Atlas.ti V.7.0.SettingNeonatal care providers working at neonatal intensive care units (NICUs) of the Leiden University Medical Center, the Netherlands, and the University of Pennsylvania School of Medicine, USA, participated in this study.ResultsIn total, 48 NICU staff members were interviewed. Reported experiences and attitudes are broadly similar for both NICUs. All interviewed providers reported positive experiences and benefits, with special emphasis on educational benefits. Recording and reviewing neonatal resuscitation is used for various learning activities, such as plenary review meetings and as tool for objective feedback. Providers reported to learn from reviewing their own performance during resuscitation, as well as from reviewing performances of others. Improved time perception, reflection on guideline compliance and acting less invasively during resuscitations were often mentioned as learning outcomes. All providers would recommend other NICUs to implement recording and reviewing neonatal resuscitation, as it is a powerful tool for learning and improving. However, they emphasised preconditions for successful implementation, such as providing information, not being punitive and focusing on the benefits for learning and improving.ConclusionRecording and reviewing neonatal resuscitation is considered highly beneficial for learning and improving resuscitation skills and is recommended by providers participating in it.

scholarly journals Healthcare Professionals’ Knowledge of Neonatal Resuscitation in Ethiopia: Analysis from 2016 National Emergency Obstetric and Newborn Care Survey

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Mulugeta Woldu Abrha ◽  
Tsrity Tadese Asresu ◽  
Alemnesh Abraha Araya ◽  
Haftom Gebrehiwot Weldearegay
Keyword(s):  
Healthcare Professionals ◽  
Healthcare Providers ◽  
Neonatal Resuscitation ◽  
Birth Asphyxia ◽  
Newborn Care ◽  
Knowledge Score ◽  
Maternal And Newborn Health ◽  
Linear Regression Method ◽  
Care Survey ◽  
National Emergency

Background. Birth asphyxia, which accounts for 31.6% of all neonatal deaths, is one of the principal causes of neonatal mortality in Ethiopia. Adequate knowledge of newborn resuscitative procedures plays an important role in early diagnoses and suitable management. However, there are limited data on healthcare professionals’ knowledge about neonatal resuscitation. Thus, this study aimed to determine the knowledge of healthcare professionals about neonatal resuscitation and factors affecting it. Methods. Data from the Ethiopian 2016 national Emergency Obstetric and Newborn Care survey of 3,804 health facilities that provided maternal and newborn health services were analyzed. We have included 3804 healthcare providers, who attended the largest number of deliveries in the last month prior to the survey, and assessed their knowledge of neonatal resuscitation. It was also determined whether certain factors were associated with healthcare providers’ knowledge through linear regression method. Result. The overall knowledge score of the healthcare providers about neonatal resuscitation ranged from 12 to 24 out of 37 items (with mean score of 18.4 (±5.47) and mean score percentage of 49%). The findings showed that providers trained on neonatal resuscitation (β=2.65, 95% CI: 0.65, 4.62; p <0.00), facilities that had guideline of neonatal resuscitation (β=2.50, 95% CI: 0.60, 3.52; p =0.01), and availability of essential equipment (β=0.95, 95% CI: 0.44, 1.45; p =0.02) were significantly associated with sufficient knowledge of neonatal resuscitation in Ethiopia. Conclusion. Overall knowledge of neonatal resuscitation was insufficient. Trained healthcare providers, having guideline on neonatal resuscitation, and availability of essential equipment were significantly associated with knowledge of neonatal resuscitation. Competency and simulation-based in-service training and refresher training complemented by supportive supervision and mentorship are helpful ways to put up providers capability to perform neonatal resuscitation.

scholarly journals The shadow challenges to improve the state essential newborn care practices in healthcare providers: evidence from a multicentre cross-sectional study in Ethiopia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ermias Sisay Chanie ◽  
Amare Kassaw ◽  
Melkamu Senbeta ◽  
Fisha Alebel GebreEyesus ◽  
Aragaw Tesfaw ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Healthcare Providers ◽  
Newborn Care ◽  
Educational Status ◽  
Care Practice ◽  
Cross Sectional ◽  
Essential Newborn Care ◽  
Multivariable Logistic Regression ◽  
Newborn Care Practice ◽  
Care Practices

Abstract Background Neonatal mortality can be reduced by providing essential newborn care. However, it is overlooked by most healthcare providers in Ethiopia. Hence, this study aims to examine immediate essential newborn care practices and associated factors among healthcare providers in Ethiopia. Methods Institution-based cross-sectional study was conducted among 214 healthcare providers from November 11 to December 19, 2020, at a selected South Gondar health facility. Data were entered into Epi-data 4.2 and then exported to STATA14.0 for analysis. Both bivariable and multivariable logistic regression with a 95% confidence interval were computed. The variable that had a p-value less than 0.25 in bivariable logistic regression was entered into the multivariable logistic regression. In multivariable logistic regression, variables having a p-value < 0.05 were considered a statistically significant association with the poor practice of essential newborn care practice. Results The overall essential newborn care practice among healthcare providers was found to be 74.8% (95% CI: 68.4, 80.2). Diploma educational status (AOR = 7.8, 95% CI:2.80–21.9), presence of workload (AOR = 9.7, 95% CI: 2.76–23.9), unavailability of drugs and vaccines (AOR = 9.8, 95% CI: 6.95–17.7), and having no training (AOR = 3.9, 95% CI: 1.73–8.92) were found to be predictors for poor essential newborn care practices. Conclusion Essential newborn care practice among healthcare providers at South Gondar health institutions was found to be low. Being diploma educational status, presence of workload, unavailability of drugs and vaccines, and having no training were found to be independent predictors for poor practice of essential newborn care. Hence, periodic evaluation and strategies are needed for those predictor variables to address the gaps.

scholarly journals Quality of care during childbirth at public health facilities in Bangladesh: a cross-sectional study using WHO/UNICEF ‘Every Mother Every Newborn (EMEN)’ standards

2019 ◽  
Vol 8 (3) ◽  
pp. e000596
Author(s):  
Sk Masum Billah ◽  
Mohiuddin Ahsanul Kabir Chowdhury ◽  
Abdullah Nurus Salam Khan ◽  
Farhana Karim ◽  
Aniqa Hassan ◽  
...  
Keyword(s):  
Healthcare Providers ◽  
Newborn Care ◽  
Health Facilities ◽  
Quality Improvement Initiative ◽  
Care Providers ◽  
Structured Interviews ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Experience Of Care ◽  
District Hospitals

BackgroundThis manuscript presents findings from a baseline assessment of health facilities in Bangladesh prior to the implementation of the ‘Every Mother Every Newborn Quality Improvement’ initiative.MethodologyA cross-sectional survey was conducted between June and August 2016 in 15 government health facilities. Structural readiness was assessed by observing the physical environment, the availability of essential drugs and equipment, and the functionality of the referral system. Structured interviews were conducted with care providers and facility managers on human resource availability and training in the maternal and newborn care. Observation of births, reviews of patient records and exit interviews with women who were discharged from the selected health facilities were used to assess the provision and experience of care.ResultsOnly six (40%) facilities assessed had designated maternity wards and 11 had newborn care corners. There were stock-outs of emergency drugs including magnesium sulfate and oxytocin in nearly all facilities. Two-thirds of the positions for medical officers was vacant in district hospitals and half of the positions for nurses was vacant in subdistrict facilities. Only 60 (45%) healthcare providers interviewed received training on newborn complication management. No health facility used partograph for labour monitoring. Blood pressure was not measured in half (48%) and urine protein in 99% of pregnant women. Only 27% of babies were placed skin to skin with their mothers. Most mothers (97%) said that they were satisfied with the care received, however, only 46% intended on returning to the same facility for future deliveries.ConclusionsSystematic implementation of quality standards to mitigate these gaps in service readiness, provision and experience of care is the next step to accelerate the country’s progress in reducing the maternal and neonatal deaths.

scholarly journals Essential newborn care practice and associated factors among health care providers in Northeast Ethiopia: a cross-sectional study

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Gebrehana Ashenef ◽  
Akine Eshete ◽  
Betregiorgis Zegeye ◽  
Tadesse Tsehay Tarekegn ◽  
Mitku Mammo Taderegew
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Newborn Care ◽  
Care Practice ◽  
Supportive Supervision ◽  
Care Providers ◽  
Cross Sectional ◽  
Essential Newborn Care ◽  
Northeast Ethiopia ◽  
Newborn Care Practice

Abstract Background Globally, 2.7 million children die during the neonatal period annually. Ethiopia is one of the ten countries with the highest number of neonatal deaths. The practice of poor essential newborn care contributes to the problem. Hence the study was conducted to assess the essential newborn care practice and associated factors among health care providers from selected health facilities in Northeast Ethiopia. Methods Facility-based cross-sectional study was conducted among health care providers working in selected health facilities in Northeast Ethiopia from February-25 to March-25, 2019. Data were collected by a pre-tested questionnaire and an observational checklist. Then data were edited into Epi-data-7.2.0.1 and analyzed by using SPSS-25 software. The degree of association was assessed using binary logistic regression analysis. P-value < 0.05 was considered statistically significant. Results A total of 256 health care providers were included in the study. Overall, 62.9% (95%CI: 57.0–68.8%), and 73.8% (95%CI: 68.4–79.2%) of the health care providers had adequate knowledge and good practice on essential newborn care activities, respectively. The presence of supportive supervision (AOR = 2.09, 95%CI = 1.07–4.11), the interest of health care providers to work at delivery room (AOR = 1.97, 95%CI = 1.00–3.88), and availability of vitamin-K (AOR = 4.81, 95%CI = 1.07–21.64) were significantly associated with essential newborn care practices. Conclusions A significant number of health care providers had inadequate knowledge and poor practice of essential newborn care. Availability of vitamin-K, the interest of the health care providers to work in the delivery room and the presence of supportive supervision were the factors affecting essential newborn care practice. Hence, giving in-service training, supportive supervision, and providing supplies should be strengthened to enhance essential newborn care activities.

scholarly journals Evaluating the use of high-fidelity simulators during mock neonatal resuscitation scenarios in trying to improve confidence in residents

2018 ◽  
Vol 6 ◽  
pp. 205031211878195 ◽  
Author(s):  
Deena Hossino ◽  
Christina Hensley ◽  
Karen Lewis ◽  
Marie Frazier ◽  
Renee Domanico ◽  
...  
Keyword(s):  
Neonatal Intensive Care ◽  
Neonatal Resuscitation ◽  
Venous Catheter ◽  
Respiratory Arrest ◽  
High Fidelity ◽  
High Fidelity Simulation ◽  
Post Intervention ◽  
Self Confidence ◽  
Simulation Based ◽  
Multiple Scenarios

Objective: The purpose of this study was to investigate the effect of the use of high-fidelity simulators with multidisciplinary teaching on self-reported confidence in residents. Methods: A total of 26 residents participated in a session led by a pediatric faculty member and a Neonatal Intensive Care Unit transport nurse using a high-fidelity pediatric simulator. Multiple scenarios were presented and each resident took turns in various roles. Pre-intervention surveys based on a 5-point Likert-type scale were given before the scenarios and were compared to the results of identical post-intervention surveys. Results: Statistically significant (p < 0.05) pre to post gains for self-confidence were observed. Improvements in confidence were analyzed using the mean difference. The largest improvement in confidence was seen in the ability to treat neonatal respiratory arrest. This was followed by the ability to supervise/run a code, and the ability to place an umbilical venous catheter. Conclusion: These results revealed that high-fidelity simulation-based training has significant positive gains in residents’ self-reported confidence.

scholarly journals Facility level factors that determine consistent delivery of essential newborn care at health centers in Ethiopia

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Binyam Fekadu ◽  
Ismael Ali ◽  
Zergu Tafesse ◽  
Hailemariam Segni
Keyword(s):  
Logistic Regression ◽  
Health Facility ◽  
Health Care Providers ◽  
Multiple Logistic Regression Analysis ◽  
Newborn Care ◽  
Outcome Variable ◽  
Care Practice ◽  
Care Providers ◽  
Essential Newborn Care ◽  
Facility Level

Abstract Background Essential newborn care (ENC) is a package of interventions which should be provided for every newborn baby regardless of body size or place of delivery immediately after birth and should be continued for at least the seven days that follows. Even though Ethiopia has endorsed the implementation of ENC, as other many counties, it has been challenged. This study was conducted to measure the level of essential newborn care practice and identify health facility level attributes for consistent delivery of ENC services by health care providers. Methods This study employed a retrospective cross-sectional study design in 425 facilities. Descriptive statistics were formulated and presented in tables. Binary logistic regression was employed to assess the statistical association between the outcome variable and the independent variables. All variables with p < 0.2 in the bivariate analysis were identified as candidate variables. Then, multiple logistic regression analysis was performed using candidate variables to determine statistically significant predictors of the consistent delivery of ENC by adjusting for possible confounders. Results A total of 273, (64.2%), of facilities demonstrated consistent delivery of ENC. Five factors—availability of essential obstetrics drugs in delivery rooms, high community score card (CSC) performances, availability of maternity waiting homes, consistent partograph use, and availability of women-friendly delivery services were included in the model. The strongest predictor of consistent delivery of essential newborn care (CD-ENC) was consistent partograph use, recording an odds ratio of 2.66 (AOR = 2.66, 95%CI: 1.71, 4.13). Similarly, providing women-friendly services was strongly associated with increased likelihood of exhibiting CD-ENC. Furthermore, facilities with essential obstetric drugs had 1.88 (AOR = 1.88, 95%CI: 1.15, 3.08) times higher odds of exhibiting consistent delivery of ENC. Conclusion The delivery of essential newborn care depends on both health provider and facility manager actions and availability of platforms to streamline relationships between the clients and health facility management.

scholarly journals Small and sick newborn care during the COVID-19 pandemic: global survey and thematic analysis of healthcare providers’ voices and experiences

2021 ◽  
Vol 6 (3) ◽  
pp. e004347
Author(s):  
Suman P N Rao ◽  
Nicole Minckas ◽  
Melissa M Medvedev ◽  
David Gathara ◽  
Prashantha Y N ◽  
...  
Keyword(s):  
Thematic Analysis ◽  
Health Personnel ◽  
Online Survey ◽  
Healthcare Providers ◽  
Newborn Care ◽  
Mitigation Strategies ◽  
Care Seeking ◽  
Care Providers ◽  
Middle Income ◽  
Sick Newborn

IntroductionThe COVID-19 pandemic is disrupting health systems globally. Maternity care disruptions have been surveyed, but not those related to vulnerable small newborns. We aimed to survey reported disruptions to small and sick newborn care worldwide and undertake thematic analysis of healthcare providers’ experiences and proposed mitigation strategies.MethodsUsing a widely disseminated online survey in three languages, we reached out to neonatal healthcare providers. We collected data on COVID-19 preparedness, effects on health personnel and on newborn care services, including kangaroo mother care (KMC), as well as disruptors and solutions.ResultsWe analysed 1120 responses from 62 countries, mainly low and middle-income countries (LMICs). Preparedness for COVID-19 was suboptimal in terms of guidelines and availability of personal protective equipment. One-third reported routine testing of all pregnant women, but 13% had no testing capacity at all. More than 85% of health personnel feared for their own health and 89% had increased stress. Newborn care practices were disrupted both due to reduced care-seeking and a compromised workforce. More than half reported that evidence-based interventions such as KMC were discontinued or discouraged. Separation of the mother–baby dyad was reported for both COVID-positive mothers (50%) and those with unknown status (16%). Follow-up care was disrupted primarily due to families’ fear of visiting hospitals (~73%).ConclusionNewborn care providers are stressed and there is lack clarity and guidelines regarding care of small newborns during the pandemic. There is an urgent need to protect life-saving interventions, such as KMC, threatened by the pandemic, and to be ready to recover and build back better.

scholarly journals Reviewing recordings of neonatal resuscitation with parents

2021 ◽  
pp. fetalneonatal-2020-320059
Author(s):  
Maria C den Boer ◽  
Mirjam Houtlosser ◽  
Ruben S G M Witlox ◽  
Roosmarijn van der Stap ◽  
Martine C de Vries ◽  
...  
Keyword(s):  
Neonatal Intensive Care ◽  
Medical Center ◽  
Qualitative Interviews ◽  
Neonatal Resuscitation ◽  
Parental Experiences ◽  
Respiratory Parameters ◽  
Positive Experiences ◽  
Set Up ◽  
And Coping ◽  
Gestational Age At Birth

BackgroundRecording of neonatal resuscitation, including video and respiratory parameters, was implemented for research and quality purposes at the neonatal intensive care unit (NICU) of the Leiden University Medical Center, and parents were offered to review the recording of their infant together with a neonatal care provider. We aimed to provide insight in parental experiences with reviewing the recording of the neonatal resuscitation of their premature infant.MethodsThis study combined participant observations during parental review of recordings with retrospective qualitative interviews with parents.ResultsParental review of recordings of neonatal resuscitation was observed on 20 occasions, reviewing recordings of 31 children (12 singletons, 8 twins and 1 triplet), of whom 4 died during admission. Median (range) gestational age at birth was 27+5 (24+5–30+3) weeks. Subsequently, 25 parents (13 mothers and 12 fathers) were interviewed.Parents reported many positive experiences, with special emphasis on the value for getting hold of the start of their infant’s life and coping with the trauma of neonatal resuscitation. Reviewing recordings of neonatal resuscitation frequently resulted in appreciation for the child, the father and the medical team. Timing and set-up of the review contributed to positive experiences. Parents considered screenshots/copies of the recording of the resuscitation of their infant as valuable keepsakes of their NICU story and reported that having the screenshots/video comforted them, especially when their child died during admission.ConclusionParents consider reviewing recordings of neonatal resuscitation as valuable. These positive parental experiences could allay concerns about sharing recordings of neonatal resuscitation with parents.

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