Neonatal Resuscitation Skill-Training Using a New Neonatal Simulator, Facilitated by Local Motivators: Two-Year Prospective Observational Study of 9000 Trainings

doi:10.3390/children9020134

. 2022 Jan 20;9(2):134.

doi: 10.3390/children9020134.

Neonatal Resuscitation Skill-Training Using a New Neonatal Simulator, Facilitated by Local Motivators: Two-Year Prospective Observational Study of 9000 Trainings

May Sissel Vadla¹, Paschal Mdoe², Robert Moshiro³, Ingunn Anda Haug⁴, Øystein Gomo⁴, Jan Terje Kvaløy^{5

6}, Bjørg Oftedal¹, Hege Ersdal^{1

7}

Affiliations

¹ Faculty of Health Sciences, University of Stavanger, 4021 Stavanger, Norway.
² Haydom Lutheran Hospital, Haydom P.O. Box 9000, Mbulu, Tanzania.
³ Muhimbili National Hospital, Dar es Salaam P.O. Box 65000, Tanzania.
⁴ Laerdal Medical, 4002 Stavanger, Norway.
⁵ Department of Mathematics and Physics, University of Stavanger, 4036 Stavanger, Norway.
⁶ Department of Research, Stavanger University Hospital, 4011 Stavanger, Norway.
⁷ Department of Anaesthesia, Stavanger University Hospital, 4011 Stavanger, Norway.

PMID: 35204855
PMCID: PMC8870207
DOI: 10.3390/children9020134

Neonatal Resuscitation Skill-Training Using a New Neonatal Simulator, Facilitated by Local Motivators: Two-Year Prospective Observational Study of 9000 Trainings

May Sissel Vadla et al. Children (Basel). 2022.

. 2022 Jan 20;9(2):134.

doi: 10.3390/children9020134.

Authors

May Sissel Vadla¹, Paschal Mdoe², Robert Moshiro³, Ingunn Anda Haug⁴, Øystein Gomo⁴, Jan Terje Kvaløy^{5

6}, Bjørg Oftedal¹, Hege Ersdal^{1

7}

Affiliations

¹ Faculty of Health Sciences, University of Stavanger, 4021 Stavanger, Norway.
² Haydom Lutheran Hospital, Haydom P.O. Box 9000, Mbulu, Tanzania.
³ Muhimbili National Hospital, Dar es Salaam P.O. Box 65000, Tanzania.
⁴ Laerdal Medical, 4002 Stavanger, Norway.
⁵ Department of Mathematics and Physics, University of Stavanger, 4036 Stavanger, Norway.
⁶ Department of Research, Stavanger University Hospital, 4011 Stavanger, Norway.
⁷ Department of Anaesthesia, Stavanger University Hospital, 4011 Stavanger, Norway.

PMID: 35204855
PMCID: PMC8870207
DOI: 10.3390/children9020134

Abstract

Globally, intrapartum-related complications account for approximately 2 million perinatal deaths annually. Adequate skills in neonatal resuscitation are required to reduce perinatal mortality. NeoNatalie Live is a newborn simulator providing immediate feedback, originally designed to accomplish Helping Babies Breathe training in low-resource settings. The objectives of this study were to describe changes in staff participation, skill-training frequency, and simulated ventilation quality before and after the introduction of "local motivators" in a rural Tanzanian hospital with 4000-5000 deliveries annually. Midwives (n = 15-27) were encouraged to perform in situ low-dose high-frequency simulation skill-training using NeoNatalie Live from September 2016 through to August 2018. Frequency and quality of trainings were automatically recorded in the simulator. The number of skill-trainings increased from 688 (12 months) to 8451 (11 months) after the introduction of local motivators in October 2017. Staff participation increased from 43% to 74% of the midwives. The quality of training performance, measured as "well done" feedback, increased from 75% to 91%. We conclude that training frequency, participation, and performance increased after introduction of dedicated motivators. In addition, the immediate constructive feedback features of the simulator may have influenced motivation and training quality performance.

Keywords: Helping Babies Breathe second edition; feedback; implementation; motivators; neonatal resuscitation; self-regulatory; simulation-based training; skill-training; training performance; ventilation quality.

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Conflict of interest statement

Øystein Gomo and Ingunn Haug are employees for Laerdal Medical. The specific roles of these authors are articulated in the ‘author contributions’ section. All other authors have no conflicts of interest to declare.

Figures

**Figure 1**
Simulation-based training at Haydom Lutheran Hospital 2010–2018. HBB; Helping Babies Breathe, LDHF; low-dose high frequency training. “Local motivators” were dedicated midwives tasked to facilitate and motivate for on-site LDHF training, following the HBB Second Edition.

**Figure 2**
NeoNatalie Live including the manikin, operating/feedback tablet device (app), and web log. Photo by Laerdal Medical.

**Figure 3**
Descriptive data of training frequency for each midwife and duration of time classified as mandatory learner. The X-axis shows the individual midwives participating in the study, numbered from 1–30. The left Y-axis shows the number of trainings per midwife during their period as mandatory learner, illustrated by the blue frequency line. The midwifes are sorted according to this frequency.

**Figure 4**
Timelines for number of skill-trainings, median number of skill-trainings per midwife, percentage of midwives participating in training and percentage of sessions receiving feedback “well done”.

See this image and copyright information in PMC

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References

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[1] Liu L., Oza S., Hogan D., Chu Y., Perin J., Zhu J., Lawn J.E., Cousens S., Mathers C., Black R.E. Global, regional, and national causes of under-5 mortality in 2000–15: An updated systematic analysis with implications for the Sustainable Development Goals. Lancet. 2016;388:3027–3035. doi: 10.1016/S0140-6736(16)31593-8. - DOI - PMC - PubMed

[2] Liu L., Oza S., Hogan D., Chu Y., Perin J., Zhu J., Lawn J.E., Cousens S., Mathers C., Black R.E. Global, regional, and national causes of under-5 mortality in 2000–15: An updated systematic analysis with implications for the Sustainable Development Goals. Lancet. 2016;388:3027–3035. doi: 10.1016/S0140-6736(16)31593-8. - DOI - PMC - PubMed

[3] Lehtonen L., Gimeno A., Llorca A.P., Vento M. Early neonatal death: A challenge worldwide. Semin. Fetal Neonatal Med. 2017;22:153–160. doi: 10.1016/j.siny.2017.02.006. - DOI - PubMed

[4] Lehtonen L., Gimeno A., Llorca A.P., Vento M. Early neonatal death: A challenge worldwide. Semin. Fetal Neonatal Med. 2017;22:153–160. doi: 10.1016/j.siny.2017.02.006. - DOI - PubMed

[5] Ersdal H.L., Eilevstjønn J., Linde J.E., Yeconia A., Mduma E.R., Kidanto H., Perlman J. Fresh stillborn and severely asphyxiated neonates share a common hypoxic–ischemic pathway. Int. J. Gynecol. Obstet. 2018;141:171–180. doi: 10.1002/ijgo.12430. - DOI - PubMed

[6] Ersdal H.L., Eilevstjønn J., Linde J.E., Yeconia A., Mduma E.R., Kidanto H., Perlman J. Fresh stillborn and severely asphyxiated neonates share a common hypoxic–ischemic pathway. Int. J. Gynecol. Obstet. 2018;141:171–180. doi: 10.1002/ijgo.12430. - DOI - PubMed

[7] Wang H., Liddell C.A., Coates M.M., Mooney M.D., Levitz C.E., Schumacher A.E., Apfel H., Iannarone M., Phillips B., Lofgren K.T., et al. Global, regional, and national levels of neonatal, infant, and under-5 mortality during 1990–2013: A systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384:957–979. doi: 10.1016/S0140-6736(14)60497-9. - DOI - PMC - PubMed

[8] Wang H., Liddell C.A., Coates M.M., Mooney M.D., Levitz C.E., Schumacher A.E., Apfel H., Iannarone M., Phillips B., Lofgren K.T., et al. Global, regional, and national levels of neonatal, infant, and under-5 mortality during 1990–2013: A systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384:957–979. doi: 10.1016/S0140-6736(14)60497-9. - DOI - PMC - PubMed

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[10] Dempsey E., Pammi M., Ryan A.C., Barrington K.J. Standardised formal resuscitation training programmes for reducing mortality and morbidity in newborn infants. [(accessed on 1 November 2021)];Cochrane Database Syst. Rev. 2015 doi: 10.1002/14651858.CD009106.pub2. Available online: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD009106.pub2/.... - DOI - DOI - PMC - PubMed

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Neonatal Resuscitation Skill-Training Using a New Neonatal Simulator, Facilitated by Local Motivators: Two-Year Prospective Observational Study of 9000 Trainings

Affiliations

Neonatal Resuscitation Skill-Training Using a New Neonatal Simulator, Facilitated by Local Motivators: Two-Year Prospective Observational Study of 9000 Trainings

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

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