Tabangin M E, Josyula S, Taylor K K, Vasquez J C, Kamath-Rayne B D
Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
School of Medicine, Ohio State University, Columbus, OH, USA.
Int Health. 2018 May 1;10(3):163-171. doi: 10.1093/inthealth/ihy017.
Helping Babies Breathe (HBB), a basic neonatal resuscitation curriculum, improves early neonatal mortality in low-resource settings. Our goal was to determine retention of resuscitation skills by different cadres of providers using the approved HBB Spanish translation in a rural clinic and community hospital in Honduras.
Twelve clinic and 37 hospital providers were trained in 1 d HBB workshops and followed from July 2012 to February 2014. Resuscitation skills were evaluated by objective structured clinical evaluations (OSCEs) at regular intervals. Clinic providers practiced monthly, whereas hospital providers were randomized to monthly practice for 6 months vs three consecutive practices at 3, 5 and 6 months.
In the rural clinic, follow-up OSCE assessment showed rapid loss of skills by 1 month after HBB training. For all providers, repeated monthly testing resulted in improvements and maintenance of OSCE performance. In the community hospital, over all time points, the group with monthly OSCEs had 2.9 greater odds of passing compared with the group who practiced less frequently. Physicians were found to have 4.3 times greater odds of passing compared with nurses.
Rapid loss of resuscitation skills occurs after an initial training. Repeated practice leads to retention of skills in all types of providers. Further investigation is warranted to determine the clinical correlation of neonatal outcomes after HBB training.
“帮助新生儿呼吸”（HBB）是一项基本的新生儿复苏课程，可降低资源匮乏地区的早期新生儿死亡率。我们的目标是在洪都拉斯的一家农村诊所和社区医院，确定使用经批准的HBB西班牙语译本对不同类别医疗人员复苏技能的保持情况。
12名诊所医疗人员和37名医院医疗人员参加了为期1天的HBB培训工作坊，并在2012年7月至2014年2月期间接受跟踪。定期通过客观结构化临床评估（OSCE）对复苏技能进行评估。诊所医疗人员每月进行练习，而医院医疗人员则被随机分为两组，一组每月练习6个月，另一组在第3、5和6个月连续练习3次。
在农村诊所，随访OSCE评估显示，HBB培训后1个月技能迅速丧失。对于所有医疗人员，每月重复测试可提高并维持OSCE表现。在社区医院，在所有时间点，每月接受OSCE评估的组通过的几率比练习较少的组高2.9倍。发现医生通过的几率比护士高4.3倍。
初次培训后复苏技能迅速丧失。反复练习可使所有类别医疗人员保持技能。有必要进行进一步调查，以确定HBB培训后新生儿结局的临床相关性。
