Helping Babies Breathe

Helping Babies Breathe Susan Niermeyer, MD, MPH, FAAP University of Colorado Denver School of Medicine Aurora, Colorado, USA

The world www.worldmapper.org 2002

The world of early neonatal deaths www.worldmapper.org 2002

Regional rates of neonatal mortality UNICEF, State of the World’s Children 2009

The world of physicians working www.worldmapper.org 2002

Inverted pyramid of neonatal resuscitation Medications Chest Compressions Positive-Pressure Ventilation Initial Steps: Drying, Warmth, Clearing the Airway, Stimulation Assessment at Birth and Simple Newborn Care All infants Some infants Few infants Wall, Lee, Niermeyer et al. IJGO 2009 136 million babies born Approx 10 million babies Approx 6 million babies < 1.4 million babies

Global Implementation Task Force Collaborators
World Health Organization (WHO)
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
United States Agency for International Development (USAID, MCHIP)
Save the Children U.S. - Saving Newborn Lives (SNL)

Helping Babies Breathe evidence base
International Liaison Committee on Resuscitation (ILCOR)
Neonatal Resuscitation: Consensus on Science and Treatment Recommendations
http://circ.ahajournals.org/cgi/content/full/
112/22_suppl/III-91
World Health Organization
Basic resuscitation guidelines (in revision)
Post-partum hemorrhage
Handwashing
Breast feeding

Action Plan

Helping Babies Breathe flipchart/simulator/learner workbook

Helping Babies Breathe facilitator flipchart

Flipchart image for learner and instructional guide for facilitator

Helping Babies Breathe learner workbook

Helping Babies Breathe learner workbook - exercises

Peer learning/teaching

Extension to the clinical setting
Clinical supervision
Case audit
Perinatal quality improvement
Bookman L et al. PAS 2009 2505.7 Singhal N, McMillan DD, Cristobal FL, et al. Health Care for Women Intl 2001; 22:569

Educational field trials
Learner evaluation
Written/verbal knowledge check (MCQs)
Bag and mask ventilation skill check
Case scenarios (OSCEs) – The Golden Minute
Educational evaluation
Learner and facilitator questionnaires
Materials – content, presentation, function
Satisfaction, self-efficacy
Focus group discussions

Educational field trials - results
Learner evaluation
Gains in knowledge, skills, performance
Significant revisions of evaluation tools
Educational evaluation
High satisfaction, feasibility, self-efficacy
Strengths: Neonatal simulator
The Golden Minute
Pictorial Action Plan and Flip Chart
Check yourself questions
Suggestions:
More time for practice
Simultaneous distribution of equipment/training
Involvement of men in advocacy activities

Implementation field trials educational outcomes
Master trainer/facilitator/provider cascade followed by scale-up
Learner evaluations of knowledge, skills, performance, competence (delivery room observation)
Learner questionnaires and focus group discussions
Satisfaction, self-efficacy among different cadres of providers
Retention of knowledge, skills

Implementation field trials clinical outcomes
Time to spontaneous breathing
Intervention (routine, initial steps, PPV)
Apgar score
Provider
Skin-to-skin positioning
Breastfeeding in first 30 minutes
Need for special care/length of stay
Outcome: stillborn, neonatal death, seizures, normal

Helping Babies Breathe

Helping Babies Breathe

by jehill3 on May 03, 2010

Accessibility

Categories

Tags

Upload Details

Usage Rights

1 Embed 1

Statistics

Helping Babies Breathe — Presentation Transcript