Centre for International Child Health, University of Melbourne, Murdoch Children's Research Institute, Royal Children's Hospital Melbourne, 50 Flemington Rd, Parkville, VIC, 3052, Australia.
National Newborn Health Coordinator, Reproductive and Child Health Department, Ministry of Health and Medical Services, Honiara, Solomon Islands.
BMC Pregnancy Childbirth. 2020 Feb 7;20(1):84. doi: 10.1186/s12884-020-2739-z.
Newborn mortality in Oceania declined slower than other regions in the past 25 years. The World Health Organization (WHO) introduced the Early Essential Newborn Care program (EENC) in 2015 in Solomon Islands, a Small Island Developing State, to address high newborn mortality. We explored knowledge and skills retention among healthcare workers following EENC coaching.
Between March 2015 and December 2017, healthcare workers in five hospitals were assessed: pre- and post-clinical coaching and at a later evaluation. Standardised written and clinical skills assessments for breathing and non-breathing baby scenarios were used. Additionally, written surveys were completed during evaluation for feedback on the EENC experience.
Fifty-three healthcare workers were included in the evaluation. Median time between initial coaching and evaluation was 21 months (IQR 18-26). Median written score increased from 44% at baseline to 89% post-coaching (p < 0.001), and was 61% at evaluation (p < 0.001). Skills assessment score was 20% at baseline and 95% post-coaching in the Breathing Baby scenario (p < 0.001). In the Non-Breathing Baby scenario, score was 63% at baseline and 86% post-coaching (p < 0.001). At evaluation, median score in the Breathing Baby scenario was 82% a reduction of 13% from post-coaching (p < 0.001) and 72% for the Non-Breathing Baby, a reduction of 14% post-coaching (p < 0.001). Nurse aides had least reduction in evaluation scores of - 2% for the Breathing Baby and midwives - 10% for the Non-Breathing Baby respectively from post-coaching to evaluation.
EENC coaching resulted in immediate improvements in knowledge and skills but declined over time. Healthcare workers who used the skills in regular practice had higher scores. Complementary quality improvement strategies are needed to sustain resuscitation skills following training over time.
Australia New Zealand Trial Registry, Retrospective Registration (12/2/2019), registration number ACTRN12619000201178.
在过去的 25 年中，大洋洲的新生儿死亡率下降速度慢于其他地区。世界卫生组织（WHO）于 2015 年在所罗门群岛引入了早期基本新生儿护理计划（EENC），以解决新生儿死亡率高的问题。我们探讨了 EENC 培训后医疗保健工作者的知识和技能保留情况。
2015 年 3 月至 2017 年 12 月，对五家医院的医疗保健工作者进行了评估：临床前和临床教练以及后期评估。使用呼吸和非呼吸婴儿情况的标准化书面和临床技能评估。此外，在评估期间还完成了书面调查，以了解对 EENC 体验的反馈。
共有 53 名医疗保健工作者参加了评估。从初次教练到评估的中位数时间为 21 个月（IQR 18-26）。书面分数中位数从基线时的 44%增加到教练后的 89%（p<0.001），并在评估时达到 61%（p<0.001）。在呼吸婴儿情景中，技能评估分数为 20%，教练后为 95%（p<0.001）。在非呼吸婴儿场景中，分数为 63%，教练后为 86%（p<0.001）。在评估中，呼吸婴儿场景的中位数分数为 82%，比教练后下降了 13%（p<0.001），非呼吸婴儿场景的分数为 72%，比教练后下降了 14%（p<0.001）。护士助手在评估中得分下降幅度最小，从教练后到评估下降了 2%，而助产士在非呼吸婴儿的得分下降了 10%。随着时间的推移，需要补充质量改进策略来维持培训后的复苏技能。
EENC 培训可立即提高知识和技能，但随着时间的推移会下降。在常规实践中使用这些技能的医疗保健工作者得分更高。随着时间的推移，需要补充质量改进策略来维持培训后的复苏技能。
澳大利亚和新西兰试验注册处，回顾性注册（2019 年 12 月 2 日），注册号 ACTRN12619000201178。
