neonatal resuscitation
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2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Jan Becker ◽  
Chase Becker ◽  
Florin Oprescu ◽  
Chiung-Jung Wu ◽  
James Moir ◽  
...  

Abstract Background In Tanzania, birth asphyxia is a leading cause of neonatal death. The aim of this study was to identify factors that influence successful neonatal resuscitation to inform clinical practice and reduce the incidence of very early neonatal death (death within 24 h of delivery). Methods This was a qualitative narrative inquiry study utilizing the 32 consolidated criteria for reporting qualitative research (COREQ). Audio-recorded, semistructured, individual interviews with midwives were conducted. Thematic analysis was applied to identify themes. Results Thematic analysis of the midwives’ responses revealed three factors that influence successful resuscitation: 1. Hands-on training (“HOT”) with clinical support during live emergency neonatal resuscitation events, which decreases fear and enables the transfer of clinical skills; 2. Unequivocal commitment to the Golden Minute® and the mindset of the midwife; and. 3. Strategies that reduce barriers. Immediately after birth, live resuscitation can commence at the mother’s bedside, with actively guided clinical instruction. Confidence and mastery of resuscitation competencies are reinforced as the physiological changes in neonates are immediately visible with bag and mask ventilation. The proclivity to perform suction initially delays ventilation, and suction is rarely clinically indicated. Keeping skilled midwives in labor wards is important and impacts clinical practice. The midwives interviewed articulated a mindset of unequivocal commitment to the baby for one Golden Minute®. Heavy workload, frequent staff rotation and lack of clean working equipment were other barriers identified that are worthy of future research. Conclusions Training in resuscitation skills in a simulated environment alone is not enough to change clinical practice. Active guidance of “HOT” real-life emergency resuscitation events builds confidence, as the visible signs of successful resuscitation impact the midwife’s beliefs and behaviors. Furthermore, a focused commitment by midwives working together to reduce birth asphyxia-related deaths builds hope and collective self-efficacy.


2022 ◽  
Vol 7 (1) ◽  
Author(s):  
Conrad Wanyama ◽  
Shobhana Nagraj ◽  
Naomi Muinga ◽  
Timothy Tuti ◽  
Hilary Edgcombe ◽  
...  

AbstractNeonatal mortality remains disproportionately high in sub-Saharan Africa partly due to insufficient numbers of adequately trained and skilled front-line health workers. Opportunities for improving neonatal care may result from upskilling frontline health workers using innovative technological approaches. This practice paper describes the key steps involved in the design, development and implementation of an innovative smartphone-based training application using an agile, human-centred design approach. The Life-saving Instruction for Emergencies (LIFE) app is a three-dimension (3D) scenario-based mobile app for smartphones and is free to download. Two clinical modules are currently included with further scenarios planned. Whilst the focus of the practice paper is on the lessons learned during the design and development process, we also share key learning related to project management and sustainability plans, which we hope will help researchers working on similar projects.


PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262446
Author(s):  
Fatima Usman ◽  
Fatimah I. Tsiga-Ahmed ◽  
Mohammed Abdulsalam ◽  
Zubaida L. Farouk ◽  
Binta W. Jibir ◽  
...  

Introduction The knowledge, attitude, and practice of emergency neonatal resuscitation are critical requirements in any facility that offers obstetric and neonatal services. This study aims to conduct a needs assessment survey and obtain individual and facility-level data on expertise and readiness for neonatal resuscitation. We hypothesize that neonatal emergency preparedness among healthcare providers in Kano, Nigeria is associated with the level of knowledge, attitudinal disposition, practice and equipment availability at the facility level. Methods A semi-structured, self-administered questionnaire was administered to a cross-section of health providers directly involved with neonatal care (n = 112) and attending a neonatal resuscitation workshop in Kano state. Information regarding knowledge, attitude, practice and facility preparedness for neonatal resuscitation was obtained. Bloom’s cut-off score and a validated basic emergency obstetric and neonatal care assessment tool were adopted to categorize outcomes. Multivariable logistic regression was employed to determine independent predictors of knowledge and practice. Results Almost half (48% and 42% respectively) of the respondents reported average level of self-assessed knowledge and comfort during resuscitation. Only 7% (95% CI:3.2–13.7) and 5% (95% CI:2.0–11.4) of health providers demonstrated good knowledge and practice scores respectively, with an overall facility preparedness of 46%. Respondents’ profession as a physician compared to nurses and midwives predicted good knowledge (aOR = 0.08, 95% CI: 0.01–0.69; p = 0.01), but not practice. Conclusion Healthcare provider’s knowledge and practice including facility preparedness for emergency neonatal resuscitation were suboptimal, despite the respondents’ relatively high self-assessed attitudinal perception. Physicians demonstrated higher knowledge compared to other health professionals. The low level of respondents’ awareness, practice, and facility readiness suggest the current weak state of secondary health systems in Kano.


2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Shannon Findlay ◽  
Morgan Swanson ◽  
Christian Junker ◽  
Mitchell Kinkor ◽  
Karisa K. Harland ◽  
...  

Abstract Background Helping Babies Breathe (HBB) is an American Academy of Pediatrics neonatal resuscitation program designed to reduce neonatal mortality in low resource settings. The 2017 neonatal mortality rate in Haiti was 28 per 1000 live births and an estimated 85 % of Haitian women deliver at home. Given this, the Community Health Initiative implemented an adapted HBB (aHBB) in Haiti to evaluate neonatal mortality. Methods Community Health Workers taught an aHBB program to laypeople, which didn’t include bag-valve-mask ventilation. Follow-up after delivery assessed for maternal and neonatal mortality and health. Results Analysis included 536 births of which 84.3 % (n=452) were attended by someone trained in aHBB. The odds of neonatal mortality was not significantly different among the two groups (aOR=0.48 [0.16-1.44]). Composite outcome of neonatal health as reported by the mother (subjective morbidity and mortality) was significantly lower in aHBB attended births (aOR=0.31 [0.14-0.70]). Conclusion This analysis of the aHBB program indicates that community training to laypersons in low resource settings may reduce neonatal ill-health but not neonatal mortality. This study is likely underpowered to find a difference in neonatal mortality. Further work is needed to evaluate which components of the aHBB program are instrumental in improving neonatal health.


2022 ◽  
Author(s):  
Bupe Mwamba ◽  
Edward K. Ameyaw ◽  
Marjory Malizyani Singogo

Abstract Background: Zambia is among the African countries with a high perinatal mortality rate. Though programs teaching medical practitioners about advanced neonatal resuscitation have reduced deaths and improved survival, more information is needed to further decrease morbidity and mortality in newborns. The objectives of this study was to implement a Perinatal Problem Identification Program (PPIP) to improve collection of information on early and late neonatal mortalities. Methods: The Perinatal Problem Identification Program was implemented in the Neonatal intensive Care unit of the Women and Newborn Hospital in Lusaka Zambia. The program started on 1 May 2019 and ended on 31 December 2019. Data entry was conducted and analysis was undertaken using the PPIP computer based software program. The PPIP software calculated neonatal deaths and their causes.Results: The Neonatal intensive care unit at women and newborn hospital recorded a total of 2640 deaths in 7 months from May 1st 2019 to 31st December 2019.The highest cause of death was prematurity with its complications at 126 (54%) in the sampled 238 recorded deaths. Followed by infection at 46 (19%) and hypoxia at 44 (18%). These deaths ranged from birth weights of less than 1000 grams to more than 2500 grams.Conclusion: The results reveal that it is possible to implement PPIP in Zambia and its use eases the audit review process, which combined with audit review meetings can improve the quality of care of neonates in the neonatal intensive care unit.


2022 ◽  
pp. 100004
Author(s):  
Mia L McLanders ◽  
Penelope M Sanderson ◽  
Stuart D Marshall ◽  
Richard M Mausling ◽  
Helen G Liley

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Ibrahim UA ◽  
Panti AA ◽  
Mohammed Y ◽  
Tunau KA ◽  
Adamu A ◽  
...  

Background: Group B Streptococcus (GBS) infection is a major cause of bacterial infections in the peri-natal period. These include amnionitis, urinary tract infections and endometritis. At birth, 50-60% of the neonates born to colonized mothers have positive cultures taken from mucus membranes and the skin. Aim: The aim of this study is to determine prevalence of GBS colonization and compare the maternal and perinatal outcomes among GBS positive and GBS negative women within 7 days postpartum. Methodology: This was a longitudinal study among pregnant women between 35-37 weeks gestation attending antenatal clinic at Usman Danfodiyo University Teaching Hospital, Sokoto. Vaginal and rectal swabs were taken from the participants and cultured for growth of Group B Streptococcus within 24 hours. The participants were followed up to 7 days post-delivery with their newborns to determine the maternal and early neonatal outcomes. Results: One hundred and eighty five (185) women were recruited and 159 (85.9%) participants were available for follow-up to determining feto-maternal outcomes. Among the participants, 3.8% (7) had GBS vaginal colonization. There was no single case of early neonatal infection, intensive neonatal resuscitation nor neonatal mortality among both GBS positive and GBS negative women. Conclusion: It has been found that the prevalence of maternal GBS colonization during pregnancy was low and neither GBS colonization nor GBS non-colonization was associated with poor maternal or poor fetal outcomes.


2021 ◽  
pp. 2101364
Author(s):  
Carolyn M. McGann ◽  
Young‐Joo Lee ◽  
Se‐Um Kim ◽  
Danielle D. Weinberg ◽  
Xincheng Zha ◽  
...  

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