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Retention and use of newborn resuscitation skills following a series of helping babies breathe trainings for midwives in rural Ghana

机译:一系列帮助婴儿在加纳农村呼吸助产士的一系列帮助婴儿呼吸助攻后的新生儿复苏技能的保留和使用

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摘要

Background: The Helping Babies Breathe (HBB) program teaches basic newborn resuscitation techniques to birth attendants in low-resource settings. Previous studies have demonstrated a decrease in mortality following training, mostly in large hospitals. However, low-volume clinics in rural regions with no physician immediately available likely experience a greater relative burden of newborn mortality. This study aimed to determine the impact of HBB trainings provided to rural Ghanaian midwives on their skills retention and on first 24 hour mortality of the newborns they serve. Methods: American Acadamy of Paediatrics (AAP)-trained Master Trainers conducted two 2-day HBB trainings and 2-day refresher courses one year later for 48 midwives from Ghanaian rural health clinics. Trainee skills were evaluated by Objective Structured Clinical Examination (OSCE) at three time points: immediately after training, four months after training, and four months after the refresher. Midwives recorded the single highest level of resuscitation performed on each newborn delivered for one year. Results: 48 midwives attended the two trainings, 32 recorded data from 2,383 deliveries, and 13 completed OSCE simulations at all three time points. The midwives’ OSCE scores decreased from immediately after training (94.9%) to four months later (81.2%, p < 0.00001). However, four months following the refresher course, scores improved to the same high level attained initially (92.7%, p = 0.0013). 5.0% of neonates required bag-mask ventilation and 0.71% did not survive, compared with a nationwide first 24 hour mortality estimate of 1.7%. Conclusions: The midwives’ performance on the simulation exercise indicates that an in-depth refresher course provided one year after the initial training likely slows the decay in skills that occurs after initial training. Our finding that 5.0% of newborns required bag-mask ventilation is consistent with global estimates. Our observed first 24 hour mortality rate of 0.71% is lower than nationwide estimates, indicating the training likely prevented deaths due to birth asphyxia.
机译:背景:帮助婴儿呼吸(HBB)计划教授基本的新生儿复苏技术在低资源环境中出生服务员。以前的研究表明,培训后的死亡率降低,主要是大医院。然而,农村地区的低批量诊所,没有医生立即有可能经历更大的新生儿死亡负担。本研究旨在确定HBB培训的影响,为Galanaian助产士提供的技能保留以及他们所服务的新生儿的前24小时死亡率。方法:美国学院的儿科(AAP)托管师培训师在加纳农村健康诊所的48名助产士举行的一年后进行了两次2天的HBB培训和2天的进修课程。实习生通过客观结构化临床检查(欧安组织)在三次时间点(欧安组织)评估:培训后立即培训,培训四个月,并在进修后四个月。助产士记录了每次新生儿的单一的复苏级别一年。结果:48助产士出席了两项培训,32个录制的数据,从2,383分娩,13个完成的欧安组织模拟,所有三个时间点。助攻的欧安全赛评分在培训(94.9%)至四个月后立即下降(81.2%,P <0.00001)。然而,在进修过程之后四个月,分数改善到最初获得的高水平(92.7%,P = 0.0013)。 5.0%的新生儿所需的袋子掩模通风和0.71%没有存活,与全国第一个24小时死亡率估计为1.7%。结论:助产士对仿真练习的表现表示,在初始训练后一年内提供的深入进修课程可能会使初步培训发生后发生的技能衰减。我们发现5.0%的新生儿需要袋掩模通风是符合全球估算的。我们观察到的前24小时死亡率为0.71%,低于全国范围的估计,表明培训可能因窒息而导致死亡。

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