G282(P)\u2005Educational outcomes of helping babies breathe training in rural rwanda

Abstract

Aims Helping Babies Breathe (HBB) is an evidence-based curriculum designed to teach basic neonatal resuscitation in low-resource countries. The aim of this study is to evaluate acquisition of knowledge and skills following HBB training in a rural district hospital in Rwanda. Method UK volunteers (1 Paediatric Registrar and 1 Paediatric nurse) working for Rwanda Neonatal Care programme collected baseline data using a scenario based objective structured clinical exam (OSCE) and bag valve mask ventilation skills test. Trainees’ skills and knowledge were evaluated using the same simulation scenario before, and 3 months after HBB training to assess retention of skills. All trainees included in the study had no previous HBB training or had completed training longer than 6 months previously. Four physicians and 9 midwives/nurses completed the HBB training package which included bag valve mask ventilation skills practice, 1 to 1 scenario drills, lectures emphasizing the importance of the Golden minute to ventilate, hypothermia awareness and assessment heart rate with consideration of continued resuscitation. ResultsAbstract G282(P) Table 1 Number assessed Passed Average OSCE score (max score 23) Before HBB training Physicians 4 0 9.8 Nurses/midwives 9 2 (22%) 11.5 After HBB training Physicians 4 4 (100%) 22 Nurses/midwives 9 9 (100%) 21.3 Conclusion HBB training resulted in significant increases in mean scores for the OSCE scenario. Although there were fewer physicians assessed, their average score before HBB training was significantly lower than scores of previously untrained nurses or midwives. However, both groups improved their average OSCE scores significantly after training to 100% pass rate (2 tailed comparison of unpaired proportions p<0.0001). Course feedback indicated a need for more sustained skills practice, particularly with bag-mask ventilation. When evaluated 3 months after initial HBB training, OSCE scores showed significant gains in neonatal resuscitation knowledge and skills. Following training, nurses and midwives, who commonly perform these skills in real-life situations, were able to perform at a similar level to physicians. Further studies are necessary to determine how to sustain this knowledge and skills over a longer time period and whether this training translates into improvements in clinical practice.