苏丹乡村助产妇在接受“帮助新生儿呼吸”培训 1 年后的技能保持情况。

Skills retention in Sudanese village midwives 1 year following Helping Babies Breathe training.

机构信息

Department of Paediatrics and Child Health, Faculty of Medicine, University of Khartoum, Khartoum, Sudan.

Department of Paediatrics and Child Health, Cork University Hospital, Cork, Co Cork, Ireland.

出版信息

Arch Dis Child. 2016 May;101(5):439-42. doi: 10.1136/archdischild-2015-309190. Epub 2016 Jan 29.

DOI:10.1136/archdischild-2015-309190

PMID:26826172

Abstract

BACKGROUND

Over 80% of deliveries in Sudan occur in isolated villages, attended by village midwives (VMWs). Upgrading newborn resuscitation skills with the Helping Babies Breathe (HBB) programme could improve newborn survival rates.

OBJECTIVE

To describe the competencies in newborn resuscitation of selected VMWs pre-HBB and post-HBB training.

METHODS

In a prospective intervention study, the VMWs' performances in the HBB Objective Structured Clinical Examination B simulated scenario (manikin requiring face-mask ventilation (FMV)) were digitally recorded and analysed prior to and 3 and 12 months following HBB training. Regular manikin-based practice was encouraged following training.

RESULTS

Pre-HBB training, 42% of 71 VMWs (of whom 61% were functionally illiterate) stimulated the non-breathing manikin by holding it by the legs and either stimulated/slapped (30.4%) or shook (12.7%) it, while 25% (18/71) provided manikin mouth-to-mouth ventilation. The low scorings on the 'preparation for birth' (0% and 3.1% at 3 and 12 months, respectively) were mainly due to failure to demonstrate the subitem of 'cleans hands'. The percentage of VMWs providing manikin FMV within the Golden Minute increased from 37.3% (25/67) to 72.3% (47/65) (p<0.005), but there were no significant differences in the number of VMWs producing at least five FMVs at 3 months (73%, 49/67) and 12 months (58%, 38/65), respectively.

CONCLUSIONS

VMWs, despite a high illiteracy rate, absorbed and sustained HBB skills for at least a year. Regular, low intensity, manikin-based skills training with peers may have helped sustain FMV, but not hand-cleansing skills.

摘要

背景

苏丹超过 80%的分娩发生在偏远村庄，由乡村助产士（VMW）接生。通过“帮助婴儿呼吸”（HBB）计划提高新生儿复苏技能可以提高新生儿的存活率。

目的

描述接受 HBB 培训前后选定的 VMW 在新生儿复苏方面的能力。

方法

在一项前瞻性干预研究中，对 VMW 在 HBB 客观结构化临床检查 B 模拟场景（需要面罩通气（FMV）的假人）中的表现进行了数字记录和分析，该场景在 HBB 培训之前和之后的 3 个月和 12 个月进行。培训后鼓励定期进行基于假人的实践。

结果

在 HBB 培训前，71 名 VMW 中的 42%（其中 61%为功能性文盲）通过抓住假人的腿来刺激未呼吸的假人，他们要么刺激/拍打（30.4%）要么摇晃（12.7%）它，而 25%（18/71）提供了假人口对口通气。“分娩准备”（分别在 3 个月和 12 个月的 0%和 3.1%）的低得分主要是由于未能展示“洗手”子项。在黄金一分钟内提供假人 FMV 的 VMW 百分比从 37.3%（67/25）增加到 72.3%（65/47）（p<0.005），但在 3 个月（73%，49/67）和 12 个月（58%，38/65）时，产生至少 5 次 FMV 的 VMW 数量没有显著差异。