Effect of newborn resuscitation training on health worker practices in Pumwani Hospital, Kenya

Birth asphyxia kills 0.7 to 1.6 million newborns a year globally with 99% of deaths in developing countries. Effective newborn resuscitation could reduce this burden of disease but the training of health-care providers in low income settings is often outdated. Our aim was to determine if a simple on...

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Veröffentlicht in:PloS one 2008-02, Vol.3 (2), p.e1599-e1599
Hauptverfasser: Opiyo, Newton, Were, Fred, Govedi, Fridah, Fegan, Greg, Wasunna, Aggrey, English, Mike
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Were, Fred
Govedi, Fridah
Fegan, Greg
Wasunna, Aggrey
English, Mike
description Birth asphyxia kills 0.7 to 1.6 million newborns a year globally with 99% of deaths in developing countries. Effective newborn resuscitation could reduce this burden of disease but the training of health-care providers in low income settings is often outdated. Our aim was to determine if a simple one day newborn resuscitation training (NRT) alters health worker resuscitation practices in a public hospital setting in Kenya. We conducted a randomised, controlled trial with health workers receiving early training with NRT (n = 28) or late training (the control group, n = 55). The training was adapted locally from the approach of the UK Resuscitation Council. The primary outcome was the proportion of appropriate initial resuscitation steps with the frequency of inappropriate practices as a secondary outcome. Data were collected on 97 and 115 resuscitation episodes over 7 weeks after early training in the intervention and control groups respectively. Trained providers demonstrated a higher proportion of adequate initial resuscitation steps compared to the control group (trained 66% vs control 27%; risk ratio 2.45, [95% CI 1.75-3.42], p
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Effective newborn resuscitation could reduce this burden of disease but the training of health-care providers in low income settings is often outdated. Our aim was to determine if a simple one day newborn resuscitation training (NRT) alters health worker resuscitation practices in a public hospital setting in Kenya. We conducted a randomised, controlled trial with health workers receiving early training with NRT (n = 28) or late training (the control group, n = 55). The training was adapted locally from the approach of the UK Resuscitation Council. The primary outcome was the proportion of appropriate initial resuscitation steps with the frequency of inappropriate practices as a secondary outcome. Data were collected on 97 and 115 resuscitation episodes over 7 weeks after early training in the intervention and control groups respectively. Trained providers demonstrated a higher proportion of adequate initial resuscitation steps compared to the control group (trained 66% vs control 27%; risk ratio 2.45, [95% CI 1.75-3.42], p&lt;0.001, adjusted for clustering). In addition, there was a statistically significant reduction in the frequency of inappropriate and potentially harmful practices per resuscitation in the trained group (trained 0.53 vs control 0.92; mean difference 0.40, [95% CI 0.13-0.66], p = 0.004). Implementation of a simple, one day newborn resuscitation training can be followed immediately by significant improvement in health workers' practices. However, evidence of the effects on long term performance or clinical outcomes can only be established by larger cluster randomised trials. 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Effective newborn resuscitation could reduce this burden of disease but the training of health-care providers in low income settings is often outdated. Our aim was to determine if a simple one day newborn resuscitation training (NRT) alters health worker resuscitation practices in a public hospital setting in Kenya. We conducted a randomised, controlled trial with health workers receiving early training with NRT (n = 28) or late training (the control group, n = 55). The training was adapted locally from the approach of the UK Resuscitation Council. The primary outcome was the proportion of appropriate initial resuscitation steps with the frequency of inappropriate practices as a secondary outcome. Data were collected on 97 and 115 resuscitation episodes over 7 weeks after early training in the intervention and control groups respectively. 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Effective newborn resuscitation could reduce this burden of disease but the training of health-care providers in low income settings is often outdated. Our aim was to determine if a simple one day newborn resuscitation training (NRT) alters health worker resuscitation practices in a public hospital setting in Kenya. We conducted a randomised, controlled trial with health workers receiving early training with NRT (n = 28) or late training (the control group, n = 55). The training was adapted locally from the approach of the UK Resuscitation Council. The primary outcome was the proportion of appropriate initial resuscitation steps with the frequency of inappropriate practices as a secondary outcome. Data were collected on 97 and 115 resuscitation episodes over 7 weeks after early training in the intervention and control groups respectively. Trained providers demonstrated a higher proportion of adequate initial resuscitation steps compared to the control group (trained 66% vs control 27%; risk ratio 2.45, [95% CI 1.75-3.42], p&lt;0.001, adjusted for clustering). In addition, there was a statistically significant reduction in the frequency of inappropriate and potentially harmful practices per resuscitation in the trained group (trained 0.53 vs control 0.92; mean difference 0.40, [95% CI 0.13-0.66], p = 0.004). Implementation of a simple, one day newborn resuscitation training can be followed immediately by significant improvement in health workers' practices. However, evidence of the effects on long term performance or clinical outcomes can only be established by larger cluster randomised trials. Controlled-Trials.com ISRCTN92218092.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>18270586</pmid><doi>10.1371/journal.pone.0001599</doi><tpages>e1599</tpages><oa>free_for_read</oa></addata></record>
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subjects Asphyxia
Babies
Cardiopulmonary resuscitation
Childrens health
Clinical trials
Clustering
Collaboration
Councils
CPR
Critical Care and Emergency Medicine
Critical Care and Emergency Medicine/Emergency Medicine
Developing countries
Health
Health care industry
Health Occupations - standards
Health sciences
Hospitals
Humans
Infant, Newborn
Intubation
Kenya
LDCs
Low income groups
Medical Errors
Medical personnel
Medical personnel training
Medical research
Morbidity
Mortality
Neonatal care
Neonates
Newborn babies
Newborn infants
Occupational health
Pediatrics
Pediatrics and Child Health
Pediatrics and Child Health/Neonatology
Pediatrics and Child Health/Pediatric Critical Care
Pediatrics and Child Health/Respiratory Pediatrics
Quality of Health Care
Randomization
Respiratory Medicine
Respiratory Medicine/Respiratory Pediatrics
Resuscitation
Resuscitation - education
Risk management
Skills
Statistical analysis
Studies
Surgery
Teaching
Training
Treatment Outcome
Workers
title Effect of newborn resuscitation training on health worker practices in Pumwani Hospital, Kenya
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