UniSHAMS, Kulliyyah of Medicine and Health Sciences, Malaysia.
Med J Malaysia. 2024 Jul;79(4):393-396.
The Neonatal Resuscitation Programme (NRP) was first introduced in Malaysia in 1996 to train doctors and nurses working in paediatrics and obstetrics departments who are involved with the care of newborns soon after delivery. Prompt and effective neonatal resuscitation has been documented to reduce mortality and neonatal asphyxia. The programme has been revised every five years and is now in the 8th edition. NRP training was made into a key performance indicator (KPI) by the Ministry of Health in 2016 for all house officers to be trained in this programme during their 2-year posting and this is usually conducted during the paediatric posting. This study aims to evaluate the retention of their knowledge, skills and competency at 3, 6, and 9 months after the initial NRP training.
A total of 34 house officers were enrolled in the study on joining the paediatric unit of Hospital Kulim. They were given the "Textbook of NRP" to prepare for the theory paper that consisted of 30 multiplechoice questions (MCQs). Two to four weeks later they went through a day of training on the resuscitation of the newborn using low-fidelity simulation manikins. They were taught to recognise a newborn who needed resuscitation after delivery, prepared the equipment for resuscitation and learned the skills of resuscitation. The skills included the initial steps, bag valve mask ventilation, intubation, cardiac massage, umbilical vein cannulation and use of medications. They were also taught the performance of objective structured clinical examination (OSCE) A and B. They were evaluated at 3, 6, and 9 months after the completion of their training using the MCQs and the performance checklist in the NRP textbook.
The results showed that there was a significant reduction in their knowledge retention as shown by their performance in multiple choice questions. Similarly, there was a significant loss of competency in their skills and competency in resuscitation using bag mask ventilation, intubation and performance of OSCE A and OSCE B. However, their performance at initial steps showed no significant reduction.
In view of the observed deterioration a refresher course in NRP before transferring out to the districts is recommended to improve their overall performance.
新生儿复苏计划（NRP）于 1996 年首次在马来西亚推出，旨在培训从事儿科和妇产科工作的医生和护士，他们在新生儿分娩后不久就参与新生儿护理。有记录显示，及时有效的新生儿复苏可以降低死亡率和新生儿窒息率。该计划每五年修订一次，目前是第 8 版。2016 年，卫生部将 NRP 培训作为所有住院医师的关键绩效指标（KPI），要求他们在 2 年的住院期间接受该计划的培训，通常在儿科住院期间进行。本研究旨在评估初始 NRP 培训后 3、6 和 9 个月时他们的知识、技能和能力的保留情况。
共有 34 名住院医师加入了吉打医院儿科病房的研究。他们被给予《NRP 教材》，为包含 30 个多项选择题（MCQ）的理论试卷做准备。两到四周后，他们使用低保真模拟人接受了一天的新生儿复苏培训。他们被教导识别分娩后需要复苏的新生儿，准备复苏设备，并学习复苏技能。这些技能包括初始步骤、气囊面罩通气、插管、心脏按摩、脐静脉插管和药物使用。他们还学习了客观结构化临床考试（OSCE）A 和 B 的操作。他们在培训完成后 3、6 和 9 个月，使用 NRP 教材中的 MCQ 和表现检查表进行评估。
结果表明，他们的知识保留率显著下降，表现在多项选择题的表现上。同样，他们的技能和复苏能力，包括气囊面罩通气、插管和 OSCE A 和 OSCE B 的表现，也显著下降。然而，他们在初始步骤的表现没有显著下降。
鉴于观察到的恶化情况，建议在转移到地区之前，在 NRP 方面进行复习课程，以提高他们的整体表现。
