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could reduce this burden of disease but the training of health-care providers in low income settings is often outdated.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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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could reduce this burden of disease but the training of health-care providers in low income settings is often outdated.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 |
doi_str_mv | 10.1371/journal.pone.0001599 |
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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<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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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<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.</description><subject>Asphyxia</subject><subject>Babies</subject><subject>Cardiopulmonary resuscitation</subject><subject>Childrens health</subject><subject>Clinical trials</subject><subject>Clustering</subject><subject>Collaboration</subject><subject>Councils</subject><subject>CPR</subject><subject>Critical Care and Emergency Medicine</subject><subject>Critical Care and Emergency Medicine/Emergency Medicine</subject><subject>Developing countries</subject><subject>Health</subject><subject>Health care industry</subject><subject>Health Occupations - standards</subject><subject>Health sciences</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>Intubation</subject><subject>Kenya</subject><subject>LDCs</subject><subject>Low income groups</subject><subject>Medical Errors</subject><subject>Medical personnel</subject><subject>Medical personnel training</subject><subject>Medical research</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Neonatal care</subject><subject>Neonates</subject><subject>Newborn babies</subject><subject>Newborn infants</subject><subject>Occupational health</subject><subject>Pediatrics</subject><subject>Pediatrics and Child Health</subject><subject>Pediatrics and Child Health/Neonatology</subject><subject>Pediatrics and Child Health/Pediatric Critical Care</subject><subject>Pediatrics and Child Health/Respiratory Pediatrics</subject><subject>Quality of Health Care</subject><subject>Randomization</subject><subject>Respiratory Medicine</subject><subject>Respiratory Medicine/Respiratory Pediatrics</subject><subject>Resuscitation</subject><subject>Resuscitation - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Opiyo, Newton</au><au>Were, Fred</au><au>Govedi, Fridah</au><au>Fegan, Greg</au><au>Wasunna, Aggrey</au><au>English, Mike</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of newborn resuscitation training on health worker practices in Pumwani Hospital, Kenya</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2008-02-13</date><risdate>2008</risdate><volume>3</volume><issue>2</issue><spage>e1599</spage><epage>e1599</epage><pages>e1599-e1599</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>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<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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