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Helping Babies Breathe implementation in Zanzibar, Tanzania
Ist Teil von
International journal of nursing practice, 2017-08, Vol.23 (4), p.n/a
Ort / Verlag
Australia: Wiley Subscription Services, Inc
Erscheinungsjahr
2017
Link zum Volltext
Quelle
Applied Social Sciences Index & Abstracts (ASSIA)
Beschreibungen/Notizen
Aim
To assess the efficacy and feasibility of implementing Helping Babies Breathe, a neonatal resuscitation programme for resource‐limited environments.
Background
This quality improvement project focused on training midwives on Helping Babies Breathe to address high rates of neonatal mortality secondary to birth asphyxia.
Methods
The convenience sample was 33 midwives in Zanzibar, Tanzania. The train‐the‐trainer strategy with repeated measures design was used to assess knowledge and skills at 3 time points. Observations were completed during “real‐time” deliveries, and a focused interview generated feedback regarding satisfaction and sustainability.
Results
Knowledge scores and resuscitation skills significantly improved and were sustained, P < .05. Of the 62 birth observations, 19% needed intervention. All were appropriately resuscitated and survived.
Conclusion
Results indicate that participants retained knowledge and skills and used them in clinical practice. Observations demonstrated that participants took appropriate actions when presented with a baby who was not breathing.
SUMMARY STATEMENT
What is already known about this topic?
Evidence supports that implementation of Helping Babies Breathe has impacted reduction in neonatal mortality and stillbirths in many resource‐limited environments.
There is limited evidence on successful methods to conduct observations after initial training and what tool would be most effective for this.
There is limited evidence around methods of sustaining implementation of Helping Babies Breathe over time.
What this paper adds:
Implementation of Helping Babies Breathe in rural Zanzibar was effective using the train‐the‐trainer implementation strategy combined with follow‐up over time. Sustainability was considered throughout the process by using reusable supplies, the train‐the‐trainer strategy, and focus group discussion regarding next steps.
Observations revealed that Helping Babies Breathe skills and knowledge were carried over to practice. Translation of skills into practice may have been influenced by time spent to ensure mastery of skills and knowledge, supportive supervision by master trainers during observations, access to reusable supplies, and the Helping Babies Breathe Action Plan tool to inform practice. Of the 62 observations, all 12 babies who had difficulty breathing at birth received effective intervention.
Use of the Helping Babies Breathe Action Plan in handout format was an effective tool to conduct “real‐time” observations.
The implications of this paper:
This paper supports that by applying key strategies such as the train‐the‐trainer model, mentoring, allocation of reusable supplies, observations with supportive feedback, and focus group discussion regarding next steps when implementing Helping Babies Breathe can result in improved clinical practice.