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Muhammed A, Shariff-Ghazali S, Md Said S, Hassan M, Lee K. Effects of an educational intervention on Nigerian midwives' intention to provide planned home birth care. Birth 2023; 50:587-595. [PMID: 36226886 DOI: 10.1111/birt.12681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 09/19/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND The majority of women in Sokoto, Nigeria prefer homebirths, but midwives are reluctant to provide care in the home setting. As such, many women continue to give birth at home alone or assisted by untrained attendants, which is associated with an increased risk for maternal and neonatal morbidity and mortality. METHODS A randomized controlled trial was conducted among 226 midwives from 10 health care facilities. The intervention group received an educational program on home birth. A validated questionnaire that evaluated knowledge, attitudes, norms, perceived control, and intention to provide planned home birth care was given at baseline, immediately after the intervention, and at three-months follow-up. Data were analyzed using linear mixed-effect model statistics. RESULTS Following the intervention, the intervention group demonstrated higher knowledge and more positive attitudes, norms, perceived control, and intention to provide planned home birth care compared with the control group (P < 0.05). No significant changes in the scores of the control group were observed during the study duration (P > 0.05). DISCUSSION Educating midwives on planned home birth increases their willingness to provide planned home birth care. Health system administrators, policymakers, and researchers may use similar interventions to promote skilled home birth attendance by midwives. Increasing the number of midwives who are willing to attend planned home births provides women at low risk for medical complications with safer options for labor, delivery, and postpartum care.
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Affiliation(s)
- Auwalu Muhammed
- Department of Nursing Sciences, College of Health Sciences, Usmanu Danfodiyo University Sokoto, Sokoto, Nigeria
| | - Sazlina Shariff-Ghazali
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Salmiah Md Said
- Department of Community Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Mairo Hassan
- Department of Obstetrics and Gynaecology, College of Health Sciences, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - Khuan Lee
- Department of Nursing and Rehabilitation, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
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Vamos CA, Foti TR, Reyes Martinez E, Pointer Z, Detman LA, Sappenfield WM. Identification of Clinician Training Techniques as an Implementation Strategy to Improve Maternal Health: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6003. [PMID: 37297607 PMCID: PMC10252379 DOI: 10.3390/ijerph20116003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 05/23/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023]
Abstract
Training is a key implementation strategy used in healthcare settings. This study aimed to identify a range of clinician training techniques that facilitate guideline implementation, promote clinician behavior change, optimize clinical outcomes, and address implicit biases to promote high-quality maternal and child health (MCH) care. A scoping review was conducted within PubMed, CINAHL, PsycInfo, and Cochrane databases using iterative searches related to (provider OR clinician) AND (education OR training). A total of 152 articles met the inclusion/exclusion criteria. The training involved multiple clinician types (e.g., physicians, nurses) and was predominantly implemented in hospitals (63%). Topics focused on maternal/fetal morbidity/mortality (26%), teamwork and communication (14%), and screening, assessment, and testing (12%). Common techniques included didactic (65%), simulation (39%), hands-on (e.g., scenario, role play) (28%), and discussion (27%). Under half (42%) of the reported training was based on guidelines or evidence-based practices. A minority of articles reported evaluating change in clinician knowledge (39%), confidence (37%), or clinical outcomes (31%). A secondary review identified 22 articles related to implicit bias training, which used other reflective approaches (e.g., implicit bias tests, role play, and patient observations). Although many training techniques were identified, future research is needed to ascertain the most effective training techniques, ultimately improving patient-centered care and outcomes.
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Affiliation(s)
- Cheryl A. Vamos
- USF’s Center of Excellence in Maternal and Child Health Education, Science & Practice, The Chiles Center, College of Public Health, University of South Florida, Tampa, FL 33612, USA
| | - Tara R. Foti
- College of Public Health, University of South Florida, Tampa, FL 33612, USA; (T.R.F.); (Z.P.)
| | - Estefanny Reyes Martinez
- College of Public Health, Florida Perinatal Quality Collaborative, University of South Florida, Tampa, FL 33612, USA;
| | - Zoe Pointer
- College of Public Health, University of South Florida, Tampa, FL 33612, USA; (T.R.F.); (Z.P.)
| | - Linda A. Detman
- The Chiles Center, College of Public Health, Florida Perinatal Quality Collaborative, University of South Florida, Tampa, FL 33612, USA; (L.A.D.); (W.M.S.)
| | - William M. Sappenfield
- The Chiles Center, College of Public Health, Florida Perinatal Quality Collaborative, University of South Florida, Tampa, FL 33612, USA; (L.A.D.); (W.M.S.)
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Lippke S, Derksen C, Keller FM, Kötting L, Schmiedhofer M, Welp A. Effectiveness of Communication Interventions in Obstetrics-A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2616. [PMID: 33807819 PMCID: PMC7967656 DOI: 10.3390/ijerph18052616] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 02/26/2021] [Accepted: 03/02/2021] [Indexed: 01/13/2023]
Abstract
(1) Background: Obstetric work requires good communication, which can be trained through interventions targeting healthcare providers and pregnant women/patients. This systematic review aims to aggregate the current state of research on communication interventions in obstetrics. (2) Methods: Using the PICOS scheme, we searched for studies published in peer-reviewed journals in English or German between 2000 and 2020. Out of 7018 results, 71 studies were included and evaluated in this synthesis using the Oxford Level of Evidence Scale. (3) Results: The 63 studies that included a communication component revealed a positive effect on different proximal outcomes (i.e., communication skills). Three studies revealed a beneficial effect of communication trainings on distal performance indicators (i.e., patient safety), but only to a limited extent. Most studies simultaneously examined different groups, however, those addressing healthcare providers were more common than those with students (61 vs. 12). Only nine studies targeted expectant mothers. Overall, the evidence level of studies was low (only 11 RCTs), with 24 studies with an evidence level I-II, 35 with level III, and 10 with level IV. (4) Conclusions: Communication trainings should be more frequently applied to improve communication of staff, students, and pregnant women and their partners, thereby improving patient safety.
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Affiliation(s)
- Sonia Lippke
- Department of Psychology and Methods, Jacobs University Bremen, 28759 Bremen, Germany; (C.D.); (F.M.K.); (L.K.); (M.S.); (A.W.)
| | - Christina Derksen
- Department of Psychology and Methods, Jacobs University Bremen, 28759 Bremen, Germany; (C.D.); (F.M.K.); (L.K.); (M.S.); (A.W.)
| | - Franziska Maria Keller
- Department of Psychology and Methods, Jacobs University Bremen, 28759 Bremen, Germany; (C.D.); (F.M.K.); (L.K.); (M.S.); (A.W.)
| | - Lukas Kötting
- Department of Psychology and Methods, Jacobs University Bremen, 28759 Bremen, Germany; (C.D.); (F.M.K.); (L.K.); (M.S.); (A.W.)
| | - Martina Schmiedhofer
- Department of Psychology and Methods, Jacobs University Bremen, 28759 Bremen, Germany; (C.D.); (F.M.K.); (L.K.); (M.S.); (A.W.)
- Aktionsbündnis Patientensicherheit e.V. (APS), 10179 Berlin, Germany
| | - Annalena Welp
- Department of Psychology and Methods, Jacobs University Bremen, 28759 Bremen, Germany; (C.D.); (F.M.K.); (L.K.); (M.S.); (A.W.)
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Fransen AF, van de Ven J, Banga FR, Mol BWJ, Oei SG. Multi-professional simulation-based team training in obstetric emergencies for improving patient outcomes and trainees' performance. Cochrane Database Syst Rev 2020; 12:CD011545. [PMID: 33325570 PMCID: PMC8094450 DOI: 10.1002/14651858.cd011545.pub2] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Simulation-based obstetric team training focuses on building a system that will anticipate errors, improve patient outcomes and the performance of clinical care teams. Simulation-based obstetric team training has been proposed as a tool to improve the overall outcome of obstetric health care. OBJECTIVES To assess the effects of simulation-based obstetric team training on patient outcomes, performance of obstetric care teams in practice and educational settings, and trainees' experience. SEARCH METHODS The Cochrane Pregnancy and Childbirth Group's Trials Register, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform (ICTRP) were searched (14 April 2020), together with references checking and hand searching the available proceedings of 2 international conferences. SELECTION CRITERIA We included randomised controlled trials (RCTs) (including cluster-randomised trials) comparing simulation-based obstetric team training with no, or other type of training. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane, to identify articles, assess methodological quality and extract data. Data from three cluster-randomised trials could be used to perform generic inverse variance meta-analyses. The meta-analyses were based on risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs). We used the GRADE approach to rate the certainty of the evidence. We used Kirkpatrick's model of training evaluation to categorise the outcomes of interest; we chose Level 3 (behavioural change) and Level 4 (patient outcome) to categorise the primary outcomes. MAIN RESULTS We included eight RCTs, six of which were cluster-randomised trials, involving more than 1000 training participants and more than 200,000 pregnancies/births. Four studies reported on outcome measures on Kirkpatrick level 4 (patient outcome), three studies on Kirkpatrick level 3 (performance in practice), two studies on Kitkpatrick level 2 (performance in educational settings), and none on Kirkpatrick level 1 (trainees' experience). The included studies were from Mexico, the Netherlands, the UK and the USA, all middle- and high-income countries. Kirkpatrick level 4 (patient outcome) Simulation-based obstetric team training may make little or no difference for composite outcomes of maternal and/or perinatal adverse events compared with no training (3 studies; n = 28,731, low-certainty evidence, data not pooled due to different composite outcome definitions). We are uncertain whether simulation-based obstetric team training affects maternal mortality compared with no training (2 studies; 79,246 women; very low-certainty evidence). However, it may reduce neonatal mortality (RR 0.70, 95% CI 0.48 to 1.01; 2 studies, 79,246 pregnancies/births, low-certainty evidence). Simulation-based obstetric team training may have little to no effect on low Apgar score compared with no training (RR 0.99, 95% 0.85 to 1.15; 2 studies; 115,171 infants; low-certainty evidence), but it probably reduces trauma after shoulder dystocia (RR 0.50, 95% CI 0.25 to 0.99; 1 study; moderate-certainty evidence) and probably slightly reduces the number of caesarean deliveries (RR 0.79, 95% CI 0.67 to 0.93; 1 study; n = 50,589; moderate-certainty evidence) Kirkpatrick level 3 (performance in practice) We found that simulation-based obstetric team training probably improves the performance of the obstetric teams in practice, compared with no training (3 studies; 2398 obstetric staff members, moderate-certainty evidence, data not pooled due to different outcome definitions). AUTHORS' CONCLUSIONS Simulation-based obstetric team training may help to improve team performance of obstetric teams, and it might contribute to improvement of specific maternal and perinatal outcomes, compared with no training. However, high-certainty evidence is lacking due to serious risk of bias and imprecision, and the effect cannot be generalised for all outcomes. Future studies investigating simulation-based obstetric team training compared to training courses with a different instructional design should carefully consider how and when to measure outcomes. Particular attention should be paid to effect measurement at the level of patient outcome, taking into consideration the low incidence of adverse maternal and perinatal events.
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Affiliation(s)
- Annemarie F Fransen
- Department of Obstetrics and Gynaecology, Máxima Medical Centre, Veldhoven, Netherlands
| | - Joost van de Ven
- Department of Obstetrics and Gynaecology, Elkerliek Hospital, Helmond, Netherlands
| | - Franyke R Banga
- Department of Obstetrics and Gynaecology, Máxima Medical Centre, Veldhoven, Netherlands
| | - Ben Willem J Mol
- Department of Obstetrics and Gynaecology, Monash University, Clayton, Australia
| | - S Guid Oei
- Department of Obstetrics and Gynaecology; Department of Electrical Engineering (University of Technology, Eindhoven), Máxima Medical Centre, Veldhoven, Netherlands
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White C, Tarrant M, Hodges R, Wallace EM, Kumar A. A pathway to establish a publicly funded home birth program in Australia. Women Birth 2019; 33:e420-e428. [PMID: 31668870 DOI: 10.1016/j.wombi.2019.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 09/24/2019] [Accepted: 09/25/2019] [Indexed: 01/19/2023]
Abstract
BACKGROUND Home births provide women a birth choice where they may feel more comfortable and confident in their ability to give birth. PROBLEM Most women in Victoria do not have publicly funded access to appropriately trained health professionals if they choose to give birth at home. METHODS This paper describes the process of setting up a publicly funded home birth service and provide details of description of the set up and governance. We also report outcomes over 9 years with respect to parity, transfer to hospital, adverse maternal and neonatal outcomes. RESULTS Of the 191 women who were still booked into the home birth program at 36 weeks gestation, 148 (77.5%) women gave birth at home and 43 (22.5%) women were transferred into the hospital. The overall rate of vaginal birth was also high among the women in the home birth program, 185 (96.9%) with no added complications ascribed to home births. Such as severe perineal trauma [n=1] 0.6% PPH [n=4] 2.7%, Apgar score less than 7 at 5min [n=0] admissions post home birth to special care nursery [n=2] 1.35%. DISCUSSION This unique study provides a detailed road map of setting up a home birth practice to facilitate other institutions keen to build a publicly funded home birth service. The birth outcome data was found to be consistent with other Australian studies on low risk home births. CONCLUSION Well-designed home birth programs following best clinical practices and procedures can provide a safe birthing option for low risk women.
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Affiliation(s)
- Colleen White
- Department of Obstetrics and Gyanecology, Monash Health, Australia
| | - Mark Tarrant
- Department of Obstetrics and Gyanecology, Monash Health, Australia
| | - Ryan Hodges
- Department of Obstetrics and Gyanecology, Monash Health, Australia
| | - Euan M Wallace
- Department of Obstetrics and Gyanecology, Monash University, Australia; Safer Care Victoria, Department of Health and Human Services, Victorian Government, Australia
| | - Arunaz Kumar
- Department of Obstetrics and Gyanecology, Monash Health, Australia; Department of Obstetrics and Gyanecology, Monash University, Australia.
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Mobile obstetric and neonatal simulation based skills training in India. Midwifery 2019; 72:14-22. [DOI: 10.1016/j.midw.2019.02.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 01/26/2019] [Accepted: 02/06/2019] [Indexed: 11/19/2022]
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Kumar A, Wallace EM, Smith C, Nestel D. Effect of an in-situ simulation workshop on home birth practice in Australia. Women Birth 2018; 32:346-355. [PMID: 30220576 DOI: 10.1016/j.wombi.2018.08.172] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 08/30/2018] [Accepted: 08/31/2018] [Indexed: 11/18/2022]
Abstract
PROBLEM Interprofessional training programs for obstetric emergencies have been introduced for up-skilling birth unit staff in hospitals but not frequently used in training midwives and paramedicine staff for home birth emergency. BACKGROUND Practical Obstetric Multiprofessional Training (PROMPT) has previously been described in the home birth setting using in-situ simulation training of home births for midwifery and paramedicine staff. AIM The aim of this study was to evaluate the benefit of the home birth simulation in clinical practice and to explore how the simulation program prepared the midwives for a birth-related emergency in a publicly funded home birth program. METHODS Midwives conducting home births, the midwifery educator and the simulated woman in labour (n=9) attended an interview that explored how the midwives' learning through simulation affected their home birth clinical practice. The simulated woman and the facilitator who conducted the simulation for more than six years were also interviewed to comment on the observed change in performance in simulation. The interview transcripts were thematically analysed. FINDINGS The themes that were identified and agreed upon, were applying learning to clinical practice, learning in teams, valuing realism, facilitating simulation based education and managing variation. DISCUSSION In-situ nature of simulation with home birth midwives and paramedical staff facilitated learning transfer and team-based approach to practice. The careful simulation design provided a breadth of experience in emergencies. CONCLUSION Applying learning to prepare for clinical emergency situations changed the midwives' approach in managing home births. This provided evidence for a change in behaviour (Level 3 Kirkpatrick's framework) and transfer of learning, leading to changed protocols (Level 4a Kirkpatrick's framework).
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Affiliation(s)
- Arunaz Kumar
- Monash Women's Services, Monash Health, Victoria, Australia; Department of Obstetrics and Gynaecology, Monash University, Victoria, Australia.
| | - Euan M Wallace
- Monash Women's Services, Monash Health, Victoria, Australia; Department of Obstetrics and Gynaecology, Monash University, Victoria, Australia
| | - Cathy Smith
- Monash Women's Services, Monash Health, Victoria, Australia; Department of Obstetrics and Gynaecology, Monash University, Victoria, Australia; School of Rural Health, Monash University, Victoria, Australia
| | - Debra Nestel
- School of Rural Health, Monash University, Victoria, Australia
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Kumar A, Sturrock S, Wallace EM, Nestel D, Lucey D, Stoyles S, Morgan J, Neil P, Schlipalius M, Dekoninck P. Evaluation of learning from Practical Obstetric Multi-Professional Training and its impact on patient outcomes in Australia using Kirkpatrick's framework: a mixed methods study. BMJ Open 2018; 8:e017451. [PMID: 29455162 PMCID: PMC5855459 DOI: 10.1136/bmjopen-2017-017451] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES The aim of this study was to evaluate the implementation of the Practical Obstetric Multi-Professional Training (PROMPT) simulation using the Kirkpatrick's framework. We explored participants' acquisition of knowledge and skills, its impact on clinical outcomes and organisational change to integrate the PROMPT programme as a credentialing tool. We also aimed to assess participants' perception of usefulness of PROMPT in their clinical practice. STUDY DESIGN Mixed methods approach with a pre-test/post-test design. SETTING Healthcare network providing obstetric care in Victoria, Australia. PARTICIPANTS Medical and midwifery staff attending PROMPT between 2013 and 2015 (n=508); clinical outcomes were evaluated in two cohorts: 2011-2012 (n=15 361 births) and 2014-2015 (n=12 388 births). INTERVENTION Attendance of the PROMPT programme, a simulation programme taught in multidisciplinary teams to facilitate teaching emergency obstetric skills. MAIN OUTCOME MEASURE Clinical outcomes compared before and after embedding PROMPT in educational practice. SECONDARY OUTCOME MEASURE Assessment of knowledge gained by participants through a qualitative analysis and description of process of embedding PROMPT in educational practice. RESULTS There was a change in the management of postpartum haemorrhage by early recognition and intervention. The key learning themes described by participants were being prepared with a prior understanding of procedures and equipment, communication, leadership and learning in a safe, supportive environment. Participants reported a positive learning experience and increase in confidence in managing emergency obstetric situations through the PROMPT programme, which was perceived as a realistic demonstration of the emergencies. CONCLUSION Participants reported an improvement of both clinical and non-technical skills highlighting principles of teamwork, communication, leadership and prioritisation in an emergency situation. An improvement was observed in management of postpartum haemorrhage, but no significant change was noted in clinical outcomes over a 2-year period after PROMPT. However, the skills acquired by medical and midwifery staff justify embedding PROMPT in educational programmes.
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Affiliation(s)
- Arunaz Kumar
- Monash Women’s Service, Monash Health, Melbourne, Australia
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia
| | - Sam Sturrock
- Monash Women’s Service, Monash Health, Melbourne, Australia
| | - Euan M Wallace
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia
| | - Debra Nestel
- School of Rural Health, Monash University, Melbourne, Australia
| | - Donna Lucey
- Monash Women’s Service, Monash Health, Melbourne, Australia
| | - Sally Stoyles
- Monash Women’s Service, Monash Health, Melbourne, Australia
| | - Jenny Morgan
- Monash Women’s Service, Monash Health, Melbourne, Australia
| | - Peter Neil
- Monash Women’s Service, Monash Health, Melbourne, Australia
| | | | - Philip Dekoninck
- Monash Women’s Service, Monash Health, Melbourne, Australia
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Australia
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Berkelhamer SK, Kamath-Rayne BD, Niermeyer S. Neonatal Resuscitation in Low-Resource Settings. Clin Perinatol 2016; 43:573-91. [PMID: 27524455 DOI: 10.1016/j.clp.2016.04.013] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Almost one quarter of newborn deaths are attributed to birth asphyxia. Systematic implementation of newborn resuscitation programs has the potential to avert many of these deaths as basic resuscitative measures alone can reduce neonatal mortality. Simplified resuscitation training provided through Helping Babies Breathe decreases early neonatal mortality and stillbirth. However, challenges remain in providing every newborn the needed care at birth. Barriers include ineffective educational systems and programming; inadequate equipment, personnel and data monitoring; and limited political and social support to improve care. Further progress calls for renewed commitments to closing gaps in the quality of newborn resuscitative care.
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Affiliation(s)
- Sara K Berkelhamer
- Department of Pediatrics, University at Buffalo, SUNY, 219 Bryant Street, Buffalo, NY 14222, USA.
| | - Beena D Kamath-Rayne
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 7009, Cincinnati, OH 45229, USA
| | - Susan Niermeyer
- Department of Pediatrics, University of Colorado, 13121 East 17th Avenue, Mail Stop 8402, Aurora, CO 80045, USA
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Paramedics׳ involvement in planned home birth: A one-year case study. Midwifery 2016; 38:71-7. [DOI: 10.1016/j.midw.2016.02.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 02/04/2016] [Accepted: 02/06/2016] [Indexed: 11/22/2022]
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