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Facilitators and barriers for implementation of a novel resuscitation quality improvement package in public referral hospitals of Nepal

BACKGROUND: Improving the healthcare providers (HCP) basic resuscitation skills can reduce intrapartum related mortality in low- and middle-income countries. However, the resuscitation intervention’s successful implementation is largely dependent on proper facilitation and context. This study aims t...

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Autores principales: Ekström, Niina, Gurung, Rejina, Humagain, Urja, Basnet, Omkar, Bhattarai, Pratiksha, Thakur, Nishant, Dhakal, Riju, KC, Ashish, Axelin, Anna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10500818/
https://www.ncbi.nlm.nih.gov/pubmed/37704967
http://dx.doi.org/10.1186/s12884-023-05989-5
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author Ekström, Niina
Gurung, Rejina
Humagain, Urja
Basnet, Omkar
Bhattarai, Pratiksha
Thakur, Nishant
Dhakal, Riju
KC, Ashish
Axelin, Anna
author_facet Ekström, Niina
Gurung, Rejina
Humagain, Urja
Basnet, Omkar
Bhattarai, Pratiksha
Thakur, Nishant
Dhakal, Riju
KC, Ashish
Axelin, Anna
author_sort Ekström, Niina
collection PubMed
description BACKGROUND: Improving the healthcare providers (HCP) basic resuscitation skills can reduce intrapartum related mortality in low- and middle-income countries. However, the resuscitation intervention’s successful implementation is largely dependent on proper facilitation and context. This study aims to identify the facilitators and barriers for the implementation of a novel resuscitation package as part of the quality improvement project in Nepal. METHODS: The study used a qualitative descriptive design. The study sites included four purposively chosen public hospitals in Nepal, where the resuscitation package (Helping Babies Breathe [HBB] training, resuscitation equipment and NeoBeat) had been implemented as part of the quality improvement project. Twenty members of the HCP, who were trained and exposed to the package, were selected through convenience sampling to participate in the study interviews. Data were collected through semi-structured interviews conducted via telephone and video calls. Twenty interview data were analyzed with a deductive qualitative content analysis based on the core components of the i-PARiHS framework. RESULTS: The findings suggest that there was a move to more systematic resuscitation practices among the staff after the quality improvement project’s implementation. This positive change was supported by a neonatal heart rate monitor (NeoBeat), which guided resuscitation and made it easier. In addition, seeing the positive outcomes of successful resuscitation motivated the HCPs to keep practicing and developing their resuscitation skills. Facilitation by the project staff enabled the change. At the same time, facilitators provided extra support to maintain the equipment, which can be a challenge in terms of sustainability, after the project. Furthermore, a lack of additional resources, an unclear leadership role, and a lack of coordination between nurses and medical doctors were barriers to the implementation of the resuscitation package. CONCLUSION: The introduction of the resuscitation package, as well as the continuous capacity building of local multidisciplinary healthcare staff, is important to continue the accelerated efforts of improving newborn care. To secure sustainable change, facilitation during implementation should focus on exploring local resources to implement the resuscitation package sustainably. TRIAL REGISTRATION: Not applicable.
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spelling pubmed-105008182023-09-15 Facilitators and barriers for implementation of a novel resuscitation quality improvement package in public referral hospitals of Nepal Ekström, Niina Gurung, Rejina Humagain, Urja Basnet, Omkar Bhattarai, Pratiksha Thakur, Nishant Dhakal, Riju KC, Ashish Axelin, Anna BMC Pregnancy Childbirth Research BACKGROUND: Improving the healthcare providers (HCP) basic resuscitation skills can reduce intrapartum related mortality in low- and middle-income countries. However, the resuscitation intervention’s successful implementation is largely dependent on proper facilitation and context. This study aims to identify the facilitators and barriers for the implementation of a novel resuscitation package as part of the quality improvement project in Nepal. METHODS: The study used a qualitative descriptive design. The study sites included four purposively chosen public hospitals in Nepal, where the resuscitation package (Helping Babies Breathe [HBB] training, resuscitation equipment and NeoBeat) had been implemented as part of the quality improvement project. Twenty members of the HCP, who were trained and exposed to the package, were selected through convenience sampling to participate in the study interviews. Data were collected through semi-structured interviews conducted via telephone and video calls. Twenty interview data were analyzed with a deductive qualitative content analysis based on the core components of the i-PARiHS framework. RESULTS: The findings suggest that there was a move to more systematic resuscitation practices among the staff after the quality improvement project’s implementation. This positive change was supported by a neonatal heart rate monitor (NeoBeat), which guided resuscitation and made it easier. In addition, seeing the positive outcomes of successful resuscitation motivated the HCPs to keep practicing and developing their resuscitation skills. Facilitation by the project staff enabled the change. At the same time, facilitators provided extra support to maintain the equipment, which can be a challenge in terms of sustainability, after the project. Furthermore, a lack of additional resources, an unclear leadership role, and a lack of coordination between nurses and medical doctors were barriers to the implementation of the resuscitation package. CONCLUSION: The introduction of the resuscitation package, as well as the continuous capacity building of local multidisciplinary healthcare staff, is important to continue the accelerated efforts of improving newborn care. To secure sustainable change, facilitation during implementation should focus on exploring local resources to implement the resuscitation package sustainably. TRIAL REGISTRATION: Not applicable. BioMed Central 2023-09-13 /pmc/articles/PMC10500818/ /pubmed/37704967 http://dx.doi.org/10.1186/s12884-023-05989-5 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Ekström, Niina
Gurung, Rejina
Humagain, Urja
Basnet, Omkar
Bhattarai, Pratiksha
Thakur, Nishant
Dhakal, Riju
KC, Ashish
Axelin, Anna
Facilitators and barriers for implementation of a novel resuscitation quality improvement package in public referral hospitals of Nepal
title Facilitators and barriers for implementation of a novel resuscitation quality improvement package in public referral hospitals of Nepal
title_full Facilitators and barriers for implementation of a novel resuscitation quality improvement package in public referral hospitals of Nepal
title_fullStr Facilitators and barriers for implementation of a novel resuscitation quality improvement package in public referral hospitals of Nepal
title_full_unstemmed Facilitators and barriers for implementation of a novel resuscitation quality improvement package in public referral hospitals of Nepal
title_short Facilitators and barriers for implementation of a novel resuscitation quality improvement package in public referral hospitals of Nepal
title_sort facilitators and barriers for implementation of a novel resuscitation quality improvement package in public referral hospitals of nepal
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10500818/
https://www.ncbi.nlm.nih.gov/pubmed/37704967
http://dx.doi.org/10.1186/s12884-023-05989-5
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