2023-09-28 14:46:10 +00:00
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abstract: 'Background: Globally, neonatal mortality accounts for nearly half of
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under-five mortality, and intrapartum related events are a leading
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cause. Despite the rise in neonatal resuscitation (NR) training programs
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in low-and middle-income countries, their impact on the quality of NR
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skills amongst providers with limited formal medical education,
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particularly those working in rural primary health centers (PHCs),
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remains incompletely understood.
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Methods: This study evaluates the impact of PRONTO International
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simulation training on the quality of NR skills in simulated
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resuscitations and live deliveries in rural PHCs throughout Bihar,
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India. Further, it explores barriers to performance of key NR skills.
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PRONTO training was conducted within CARE India''s AMANAT intervention, a
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maternal and child health quality improvement project. Performance in
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simulations was evaluated using video-recorded assessment simulations at
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weeks 4 and 8 of training. Performance in live deliveries was evaluated
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in real time using a mobile-phone application. Barriers were explored
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through semi-structured interviews with simulation facilitators.
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Results: In total, 1342 nurses participated in PRONTO training and 226
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NR assessment simulations were matched by PHC and evaluated. From week 4
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to 8 of training, proper neck extension, positive pressure ventilation
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(PPV) with chest rise, and assessment of heart rate increased by 14\%,
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19\%, and 12\% respectively (all p <= 0.01). No difference was noted in
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stimulation, suction, proper PPV rate, or time to completion of key
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steps. In 252 live deliveries, identification of non-vigorous neonates,
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use of suction, and use of PPV increased by 21\%, 25\%, and 23\%
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respectively (all p < 0.01) between weeks 1-3 and 4-8. Eighteen
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interviews revealed individual, logistical, and cultural barriers to key
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NR skills.
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Conclusion: PRONTO simulation training had a positive impact on the
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quality of key skills in simulated and live resuscitations throughout
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Bihar. Nevertheless, there is need for ongoing improvement that will
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likely require both further clinical training and addressing barriers
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that go beyond the scope of such training. In settings where clinical
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outcome data is unreliable, data triangulation, the process of
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synthesizing multiple data sources to generate a better-informed
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evaluation, offers a powerful tool for guiding this process.'
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affiliation: 'Vail, B (Corresponding Author), Univ Calif San Francisco, Dept Pediat,
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550 16th St,4th Floor,Box 0110, San Francisco, CA 94158 USA.
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Vail, Brennan; Morgan, Melissa C., Univ Calif San Francisco, Dept Pediat, 550 16th
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St,4th Floor,Box 0110, San Francisco, CA 94158 USA.
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Morgan, Melissa C., London Sch Hyg \& Trop Med, Maternal Adolescent Reprod \& Child
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Hlth Ctr, Keppel St, London WC1E 7HT, England.
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Morgan, Melissa C.; Spindler, Hilary; Walker, Dilys M., Univ Calif San Francisco,
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Inst Global Hlth Sci, 550 16th St, San Francisco, CA 94158 USA.
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Christmas, Amelia, PRONTO Int, State RMNCH A Unit, C-16 Krishi Nagar, Patna 80002,
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Bihar, India.
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Cohen, Susanna R., Univ Utah, Coll Nursing, 10 South 2000 East, Salt Lake City,
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UT 84112 USA.
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Walker, Dilys M., Univ Calif San Francisco, Dept Obstet \& Gynecol \& Reprod Serv,
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1001 Potrero Ave, San Francisco, CA 94110 USA.
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Walker, Dilys M., PRONTO Int, 1820 E Thomas St APT 16, Seattle, WA 98112 USA.'
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article-number: '291'
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author: Vail, Brennan and Morgan, Melissa C. and Spindler, Hilary and Christmas, Amelia
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and Cohen, Susanna R. and Walker, Dilys M.
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author-email: brennan.vail@ucsf.edu
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author_list:
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- family: Vail
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given: Brennan
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- family: Morgan
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given: Melissa C.
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- family: Spindler
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given: Hilary
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- family: Christmas
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given: Amelia
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- family: Cohen
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given: Susanna R.
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- family: Walker
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given: Dilys M.
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da: '2023-09-28'
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doi: 10.1186/s12887-018-1254-0
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eissn: 1471-2431
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files: []
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journal: BMC PEDIATRICS
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keywords: 'Neonatal resuscitation; Bihar; India; Simulation Training; Barriers to
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Care'
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keywords-plus: 'EDUCATIONAL-IMPACT; NEWBORN CARE; MORTALITY; PROGRAM; IMPROVEMENTS;
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DELIVERY; DEATHS'
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language: English
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month: SEP 3
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number-of-cited-references: '37'
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orcid-numbers: Medvedev, Melissa/0000-0003-3457-8452
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papis_id: bcc33c57c5952e1d6b367fcf1ec29a77
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ref: Vail2018powerpractice
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times-cited: '18'
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title: 'The power of practice: simulation training improving the quality of neonatal
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resuscitation skills in Bihar, India'
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000443426600003
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usage-count-last-180-days: '0'
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usage-count-since-2013: '6'
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volume: '18'
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web-of-science-categories: Pediatrics
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year: '2018'
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