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首页> 外文期刊>BMC Pediatrics >Evaluation of Helping Babies Breathe Quality Improvement Cycle (HBB-QIC) on retention of neonatal resuscitation skills six months after training in Nepal
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Evaluation of Helping Babies Breathe Quality Improvement Cycle (HBB-QIC) on retention of neonatal resuscitation skills six months after training in Nepal

机译：在尼泊尔训练六个月后评估帮助婴儿呼吸质量改善周期（HBB-QIC）保留新生儿复苏技能的评估

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Background Each year 700,000 infants die due to intrapartum-related complications. Implementation of Helping Babies Breathe (HBB)-a simplified neonatal resuscitation protocol in low-resource clinical settings has shown to reduce intrapartum stillbirths and first-day neonatal mortality. However, there is a lack of evidence on the effect of different HBB implementation strategies to improve and sustain the clinical competency of health workers on bag-and-mask ventilation. This study was conducted to evaluate the impact of multi-faceted implementation strategy for HBB, as a quality improvement cycle (HBB-QIC), on the retention of neonatal resuscitation skills in a tertiary hospital of Nepal. Methods A time-series design was applied. The multi-faceted intervention for HBB-QIC included training, daily bag-and-mask skill checks, preparation for resuscitation before every birth, self-evaluation and peer review on neonatal resuscitation skills, and weekly review meetings. Knowledge and skills were assessed through questionnaires, skill checklists, and Objective Structured Clinical Examinations (OSCE) before implementation of the HBB-QIC, immediately after HBB training, and again at 6 months. Means were compared using paired t-tests, and associations between skill retention and HBB-QIC components were analyzed using logistic regression analysis. Results One hundred thirty seven health workers were enrolled in the study. Knowledge scores were higher immediately following the HBB training, 16.4 ± 1.4 compared to 12.8 ± 1.6 before (out of 17), and the knowledge was retained 6 months after the training (16.5 ± 1.1). Bag-and-mask skills improved immediately after the training and were retained 6 months after the training. The retention of bag-and-mask skills was associated with daily bag-and-mask skill checks, preparation for resuscitation before every birth, use of a self-evaluation checklist, and attendance at weekly review meetings. The implementation strategies with the highest association to skill retention were daily bag-and-mask skill checks (RR-5.1, 95% CI 1.9–13.5) and use of self-evaluation checklists after every delivery (RR-3.8, 95% CI 1.4–9.7). Conclusions Health workers who practiced bag-and-mask skills, prepared for resuscitation before every birth, used self-evaluation checklists, and attended weekly review meetings were more likely to retain their neonatal resuscitation skills. Further studies are required to evaluate HBB-QIC in primary care settings, where the number of deliveries is gradually increasing. Trial registration ISRCTN97846009 . Date of Registration- 15 August 2012.
机译：背景技术每年有700,000例婴儿因与产内相关的并发症而死亡。在资源匮乏的临床环境中实施简化的婴儿呼吸复苏（HBB）新生儿方案已显示可降低分娩死胎和新生儿的第一天死亡率。但是，缺乏证据表明不同的HBB实施策略可改善并维持医护人员在口罩和面罩通气方面的临床能力。这项研究的目的是评估作为质量改进周期（HBB-QIC）的HBB多方面实施策略对尼泊尔三级医院保留新生儿复苏技术的影响。方法采用时间序列设计。 HBB-QIC的多方面干预措施包括培训，每日检查口罩和口罩的技能，准备在每次分娩前进行复苏，自我评估和新生儿复苏技能的同行评审以及每周的评审会议。在实施HBB-QIC之前，紧接HBB培训之后以及6个月时，通过问卷，技能清单和客观结构临床检查（OSCE）评估知识和技能。使用配对t检验比较平均值，并使用逻辑回归分析分析技能保留与HBB-QIC成分之间的关​​联。结果137名卫生工作者参加了这项研究。在HBB培训后，知识得分立即更高，为16.4±1.4，而之前（在17个评分中）为12.8±1.6，并且在培训后6个月保留了知识（16.5±1.1）。训练后立即提高了口罩和口罩的技能，并在训练后6个月保留了该技能。保留口罩和口罩的技能与每天进行口罩和口罩的技能检查，每次分娩前复苏的准备，使用自我评估清单以及参加每周检查会议有关。与技能保留相关性最高的实施策略是每天进行口罩和口罩技能检查（RR-5.1，95％CI 1.9–13.5）和每次分娩后使用自我评估清单（RR-3.8，95％CI 1.4） –9.7）。结论练习过手袋和口罩技能，准备在每次分娩前进行复苏，使用自我评估清单并参加每周复查会议的卫生工作者更有可能保留他们的新生儿复苏技能。需要进一步的研究以评估分娩数量逐渐增加的初级保健机构中的HBB-QIC。试用注册ISRCTN97846009。注册日期-2012年8月15日。

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