Bradfield Michael, Goodwin Laura, Bates Sarah, Tinnion Robert, Hedge Sally, Kerslake Dawn, Madar John, Murcott Lucy, Tyler Wendy, Yates James, Powell Anna, Hall Louise
Resuscitation Council UK; Bournemouth University ORCID iD: https://orcid.org/0000-0003-1131-3638.
University of the West of England ORCID iD: https://orcid.org/0000-0002-9118-4620.
Br Paramed J. 2024 Dec 1;9(3):44-52. doi: 10.29045/14784726.2024.12.9.3.44.
Unplanned out-of-hospital births (UOHBs) are associated with poorer outcomes for babies, especially those born prematurely. The current Newborn Life Support (NLS) course offered by Resuscitation Council UK (RCUK) is not designed to address the challenges associated with birth out of hospital. A new course was developed to address these challenges. This study aimed to evaluate the impact of this course on attendees' knowledge and confidence in supporting transition, resuscitation, stabilisation and onward transfer of newborns in an out-of-hospital setting.
A convergent mixed-methods approach was used consisting of pre-, post- and follow-up surveys and a post-course multiple-choice questionnaire (MCQ). The surveys asked participants to rate their confidence, on a five-point Likert scale (from 'Underconfident/fearful' to 'Very confident') across seven domains of NLS, as well as making an individual assessment of provider confidence before and after the course. Free-text comments were collected and analysed using thematic analysis.
Attendees comprised multidisciplinary staff from the South West of England. The pre-course survey was completed by 32 of the 33 participants, the post-course survey by 31 and the MCQ by all 33. A total of 18 participants completed the follow-up survey. Analysis showed a significant, positive change in confidence across NLS domains between the pre- and post-course surveys (p <0.0001).The follow-up survey data showed self-reported increases in knowledge and largely sustained confidence. The qualitative analysis revealed themes relating to the participants' feelings about managing babies born out of hospital.
The proof-of-concept OH-NLS course appears to address the learning needs of the target professional group, and the results suggest improved knowledge and confidence in the immediate management of babies born out of hospital. Further evaluation is required to determine whether such training has a long-term impact and translates into improved outcomes across a larger group of participants.
非计划的院外分娩（UOHBs）与婴儿较差的结局相关，尤其是早产婴儿。英国复苏委员会（RCUK）提供的现行新生儿生命支持（NLS）课程并非旨在应对与院外分娩相关的挑战。因此开发了一门新课程来应对这些挑战。本研究旨在评估该课程对参与者在院外环境中支持新生儿过渡、复苏、稳定和后续转运方面的知识和信心的影响。
采用了一种收敛性混合方法，包括课前、课后和随访调查以及课程后的多项选择题问卷（MCQ）。调查要求参与者在从“信心不足/恐惧”到“非常有信心”的五点李克特量表上，对NLS的七个领域的信心进行评分，并对课程前后的提供者信心进行个人评估。收集自由文本评论并使用主题分析进行分析。
参与者包括来自英格兰西南部的多学科工作人员。33名参与者中有32名完成了课前调查，31名完成了课后调查，所有33名完成了MCQ。共有18名参与者完成了随访调查。分析表明，课前和课后调查之间，NLS各领域的信心有显著的积极变化（p<0.0001）。随访调查数据显示，自我报告的知识有所增加，信心在很大程度上得以维持。定性分析揭示了与参与者对管理院外出生婴儿的感受相关的主题。
概念验证的院外NLS课程似乎满足了目标专业群体的学习需求，结果表明在院外出生婴儿的即时管理方面知识和信心有所提高。需要进一步评估以确定此类培训是否具有长期影响，并能否在更大的参与者群体中转化为更好的结局。
