Children's Hospital of Philadelphia, 3400 Civic Center Blvd, Philadelphia, PA 19104, United States.
Children's Hospital of Philadelphia, 3400 Civic Center Blvd, Philadelphia, PA 19104, United States; Botswana-UPenn Partnership, 214 Independence Ave, Gaborone, Botswana; University of Botswana School of Medicine, Gaborone, Botswana.
Resuscitation. 2015 Mar;88:57-62. doi: 10.1016/j.resuscitation.2014.12.007. Epub 2014 Dec 19.
Worldwide, 6.6 million children die each year, partly due to a failure to recognize and treat acutely ill children. Programs that improve provider recognition and treatment initiation may improve child survival.
Describe provider characteristics and hospital resources during a contextualized pediatric resuscitation training program in Botswana and determine if training impacts provider knowledge retention.
DESIGN/METHODS: The American Heart Association's Pediatric Emergency Assessment Recognition and Stabilization (PEARS) course was contextualized to Botswana resources and practice guidelines in this observational study. A cohort of facility-based nurses (FBN) was assessed prior to and 1-month following training. Survey tools assessed provider characteristics, cognitive knowledge and confidence and hospital pediatric resources. Data analysis utilized Fisher's exact, Chi-square, Wilcoxon rank-sum and linear regression where appropriate.
61 healthcare providers (89% FBNs, 11% physicians) successfully completed PEARS training. Referral facilities had more pediatric specific equipment and high-flow oxygen. Median frequency of pediatric resuscitation was higher in referral compared to district level FBN's (5 [3,10] vs. 2 [1,3] p=0.007). While 50% of FBN's had previous resuscitation training, none was pediatric specific. Median provider confidence improved significantly after training (3.8/5 vs. 4.7/5, p<0.001), as did knowledge of correct management of acute pneumonia and diarrhea (44% vs. 100%, p<0.001, 6% vs. 67%, p<0.001, respectively).
FBN's in Botswana report frequent resuscitation of ill children but low baseline training. Provider knowledge for recognition and initial treatment of respiratory distress and shock is low. Contextualized training significantly increased FBN provider confidence and knowledge retention 1-month after training.
全球每年有 660 万儿童死亡，部分原因是未能识别和治疗急性病儿童。提高提供者识别和治疗启动能力的项目可能会提高儿童生存率。
描述博茨瓦纳背景下儿科复苏培训计划中提供者的特征和医院资源，并确定培训是否会影响提供者知识的保留。
本观察性研究中，将美国心脏协会的儿科急救评估识别与稳定（PEARS）课程与博茨瓦纳资源和实践指南进行了调整。在培训前后评估了一组医疗机构护士（FBN）。调查工具评估了提供者的特征、认知知识和信心以及医院儿科资源。适当情况下使用 Fisher 精确检验、卡方检验、Wilcoxon 秩和检验和线性回归进行数据分析。
61 名医疗保健提供者（89%的 FBN，11%的医生）成功完成了 PEARS 培训。转诊机构拥有更多儿科专用设备和高流量氧气。与地区级 FBN 相比，转诊机构的儿科复苏频率更高（中位数[范围]：5[3,10]次与 2[1,3]次，p=0.007）。虽然 50%的 FBN 有过以前的复苏培训，但都不是儿科专用的。培训后，提供者的信心显著提高（中位数从 3.8/5 提高到 4.7/5，p<0.001），对急性肺炎和腹泻的正确管理知识也显著提高（分别从 44%提高到 100%，p<0.001，从 6%提高到 67%，p<0.001）。
博茨瓦纳的 FBN 报告经常对病童进行复苏，但基础培训水平较低。对识别和初始治疗呼吸窘迫和休克的提供者知识水平较低。经过调整的培训显著提高了 FBN 提供者的信心和知识保留，在培训后 1 个月仍然有效。
