Effect of skill drills on neonatal ventilation performance in a simulated setting—observation study in Nepal

Gurung, Rejina; Gurung, Abhishek; Sunny, Avinash K; Basnet, Omkar; Shrestha, Shree Krishna; Gomo, Øystein; Myklebust, Helge; Girnary, Sakina; Kc, Ashish

doi:10.1186/s13287-019-1421-8

Cited by 4 publications

(4 citation statements)

References 30 publications

(32 reference statements)

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“…25 88 Recent uses of technology to cut costs and ease logistic burden of implementation include training via video conferencing 61 and mobile apps 41 as well as the use of a highfidelity mannequin that provides feedback based on resuscitation performance. 58 HBB implementation translates into meaningfully improved skills and knowledge as demonstrated through multiple studies in which authors cite improved average OSCE scores and pass rates on knowledge assessments. 38,52,72,74,77 Factors such as number of deliveries attended, previous resuscitation training, and worker cadre have been cited as having an impact on knowledge and skill acquisition and retention after HBB training.…”

Section: Newborn Outcomesmentioning

confidence: 98%

Implementation of the Helping Babies Breathe Training Program: A Systematic Review

et al. 2020

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CONTEXT: Helping Babies Breathe (HBB) is a well-established neonatal resuscitation program designed to reduce newborn mortality in low-resource settings. OBJECTIVES: In this literature review, we aim to identify challenges, knowledge gaps, and successes associated with each stage of HBB programming. DATA SOURCES: Databases used in the systematic search included Medline, POPLINE, Cumulative Index to Nursing and Allied Health Literature, Latin American and Caribbean Health Sciences Literature, African Index Medicus, Cochrane, and Index Medicus. STUDY SELECTION: All articles related to HBB, in any language, were included. Article quality was assessed by using the Grading of Recommendations Assessment, Development, and Evaluation framework. DATA EXTRACTION: Data were extracted if related to HBB, including its implementation, acquisition and retention of HBB knowledge and skills, changes in provider behavior and clinical care, or the impact on newborn outcomes. RESULTS: Ninety-four articles met inclusion criteria. Barriers to HBB implementation include staff turnover and limited time or focus on training and practice. Researchers of several studies found HBB cost-effective. Posttraining decline in knowledge and skills can be prevented with low-dose high-frequency refresher trainings, on-the-job practice, or similar interventions. Impact of HBB training on provider clinical practices varies. Although not universal, researchers in multiple studies have shown a significant association of decreased perinatal mortality with HBB implementation. LIMITATIONS: In addition to not conducting a gray literature search, articles relating only to Essential Care for Every Baby or Essential Care for Small Babies were not included in this review. CONCLUSIONS: Key challenges and requirements for success associated with each stage of HBB programming were identified. Despite challenges in obtaining neonatal mortality data, the program is widely believed to improve neonatal outcomes in resource-limited settings.

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Section: Newborn Outcomesmentioning

confidence: 98%

Implementation of the Helping Babies Breathe Training Program: A Systematic Review

et al. 2020

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“…There is evidence to support the use of low dose, high frequency practice to improve skills retention. (13)(14)(15) Ideas generated by participants on how to implement such practice included using the "review key knowledge" section of each page of the provider guide to frequently test skills with a partner, and incorporating ECEB into pre-service education of nursing trainees and house staff o cers by dividing the course into hour-long sessions. Finally, teaching new providers both disseminates the information and reinforces the knowledge of the local champion leading the educational session.…”

Section: Discussionmentioning

confidence: 99%

Adaptation of Essential Care for Every Baby Educational Program to Improve Infant Outcomes in the Context of Zika

Prasanphanich

Martin-Herz

Carter

et al. 2022

Preprint

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Background: The outbreak and ongoing transmission of Zika virus provided an opportunity to strengthen essential newborn care and early childhood development systems through assistance by US Agency for International Development Applying Science to Strengthen and Improve Systems (USAID ASSIST). There is an evidence gap on the impact of Helping Babies Survive educational programs, including Essential Care for Every Baby (ECEB), beyond early mortality. The objective was to create a system of sustainable training dissemination which improves newborn care-related quality indicators in the context of Zika.Methods: USAID ASSIST supported a series of technical assistance visits by the American Academy of Pediatrics (AAP) in four Caribbean countries to strengthen the clinical capacity in care of children potentially affected by Zika through dissemination of ECEB, teaching QI methodology, coaching visits, and development of clinical care guidelines. ECEB was adapted to emphasize physical exam findings related to Zika. The first series of workshops were facilitated by AAP technical advisors and the second series were facilitated by the newly trained local champions. Quality care was monitored with performance indicators at 134 health facilities.Results: A repeated measures (pre-post) ANOVA was conducted, revealing significant pre-post knowledge gains [F(1)=197.9, p<0.001] on knowledge check scores. Certain performance indicators related to ECEB practices demonstrated significant changes and midline shift on the run chart in four countries.Conclusion: ECEB can be adapted to incorporate important local practices, causes of neonatal morbidity and mortality, and differing healthcare system structures, leading to improved performance of health systems.

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“…One of the primary challenges for HBB, as with any educational program however, is the knowledge and skills drop-off that occurs over time [ 9 – 13 ]. Frequent practice both with self and peer-to-peer learning [ 11 , 14 , 15 ], as well as expert feedback have been shown to be helpful methods to sustain competencies [ 16 ]. In a recent qualitative study examining 10 years of HBB facilitator data, one of the themes that emerged as critical to the program was “frequent and sustained hands-on practice during and after the course [ 5 ].”…”

Section: Introductionmentioning

confidence: 99%

Utilization of a novel mobile application, “HBB Prompt”, to reduce Helping Babies Breathe skills decay

Chan

Merali

Mistry

et al. 2023

PLOS Glob Public Health

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Background Helping Babies Breathe (HBB) is a newborn resuscitation training program designed to reduce neonatal mortality in low- and middle-income countries. However, skills decay after initial training is a significant barrier to sustained impact. Objective To test whether a mobile app, HBB Prompt, developed with user-centred design, helps improve skills and knowledge retention after HBB training. Methods HBB Prompt was created during Phase 1 of this study with input from HBB facilitators and providers from Southwestern Uganda recruited from a national HBB provider registry. During Phase 2, healthcare workers (HCWs) in two community hospitals received HBB training. One hospital was randomly assigned as the intervention hospital, where trained HCWs had access to HBB Prompt, and the other served as control without HBB Prompt (NCT03577054). Participants were evaluated using the HBB 2.0 knowledge check and Objective Structured Clinical Exam, version B (OSCE B) immediately before and after training, and 6 months post-training. The primary outcome was difference in OSCE B scores immediately after training and 6 months post-training. Results Twenty-nine HCWs were trained in HBB (17 in intervention, 12 in control). At 6 months, 10 HCW were evaluated in intervention and 7 in control. In intervention and control respectively, the median OSCE B scores were: 7 vs. 9 immediately before training, 17 vs. 21 immediately after training, and 12 vs. 13 at 6 months after training. Six months after training, the median difference in OSCE B scores was -3 (IQR -5 to -1) in intervention and -8 (IQR -11 to -6) in control (p = 0.02). Conclusion HBB Prompt, a mobile app created by user-centred design, improved retention of HBB skills at 6 months. However, skills decay remained high 6 months after training. Continued adaptation of HBB Prompt may further improve maintenance of HBB skills.

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Effect of skill drills on neonatal ventilation performance in a simulated setting—observation study in Nepal

Cited by 4 publications

References 30 publications

Implementation of the Helping Babies Breathe Training Program: A Systematic Review

Implementation of the Helping Babies Breathe Training Program: A Systematic Review

Adaptation of Essential Care for Every Baby Educational Program to Improve Infant Outcomes in the Context of Zika

Utilization of a novel mobile application, “HBB Prompt”, to reduce Helping Babies Breathe skills decay

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