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Helping Babies Breathe (HBB) training: What happens to knowledge and skills over time?

BACKGROUND: The first minutes after birth are critical to reducing neonatal mortality. Helping Babies Breathe (HBB) is a simulation-based neonatal resuscitation program for low resource settings. We studied the impact of initial HBB training followed by refresher training on the knowledge and skills...

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Autores principales: Bang, Akash, Patel, Archana, Bellad, Roopa, Gisore, Peter, Goudar, Shivaprasad S., Esamai, Fabian, Liechty, Edward A., Meleth, Sreelatha, Goco, Norman, Niermeyer, Susan, Keenan, William, Kamath-Rayne, Beena D., Little, George A., Clarke, Susan B., Flanagan, Victoria A., Bucher, Sherri, Jain, Manish, Mujawar, Nilofer, Jain, Vinita, Rukunga, Janet, Mahantshetti, Niranjana, Dhaded, Sangappa, Bhandankar, Manisha, McClure, Elizabeth M., Carlo, Waldemar A., Wright, Linda L., Hibberd, Patricia L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5120476/
https://www.ncbi.nlm.nih.gov/pubmed/27875999
http://dx.doi.org/10.1186/s12884-016-1141-3
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author Bang, Akash
Patel, Archana
Bellad, Roopa
Gisore, Peter
Goudar, Shivaprasad S.
Esamai, Fabian
Liechty, Edward A.
Meleth, Sreelatha
Goco, Norman
Niermeyer, Susan
Keenan, William
Kamath-Rayne, Beena D.
Little, George A.
Clarke, Susan B.
Flanagan, Victoria A.
Bucher, Sherri
Jain, Manish
Mujawar, Nilofer
Jain, Vinita
Rukunga, Janet
Mahantshetti, Niranjana
Dhaded, Sangappa
Bhandankar, Manisha
McClure, Elizabeth M.
Carlo, Waldemar A.
Wright, Linda L.
Hibberd, Patricia L.
author_facet Bang, Akash
Patel, Archana
Bellad, Roopa
Gisore, Peter
Goudar, Shivaprasad S.
Esamai, Fabian
Liechty, Edward A.
Meleth, Sreelatha
Goco, Norman
Niermeyer, Susan
Keenan, William
Kamath-Rayne, Beena D.
Little, George A.
Clarke, Susan B.
Flanagan, Victoria A.
Bucher, Sherri
Jain, Manish
Mujawar, Nilofer
Jain, Vinita
Rukunga, Janet
Mahantshetti, Niranjana
Dhaded, Sangappa
Bhandankar, Manisha
McClure, Elizabeth M.
Carlo, Waldemar A.
Wright, Linda L.
Hibberd, Patricia L.
author_sort Bang, Akash
collection PubMed
description BACKGROUND: The first minutes after birth are critical to reducing neonatal mortality. Helping Babies Breathe (HBB) is a simulation-based neonatal resuscitation program for low resource settings. We studied the impact of initial HBB training followed by refresher training on the knowledge and skills of the birth attendants in facilities. METHODS: We conducted HBB trainings in 71 facilities in the NICHD Global Network research sites (Nagpur and Belgaum, India and Eldoret, Kenya), with a 6:1 ratio of facility trainees to Master Trainers (MT). Because of staff turnover, some birth attendants (BA) were trained as they joined the delivery room staff, after the initial training was completed (catch-up initial training). We compared pass rates for skills and knowledge pre- and post- initial HBB training and following refresher training among active BAs. An Objective Structured Clinical Examination (OSCE) B tested resuscitation skill retention by comparing post-initial training performance with pre-refresher training performance. We identified factors associated with loss of skills in pre-refresher training performance using multivariable logistic regression analysis. Daily bag and mask ventilation practice, equipment checks and supportive supervision were stressed as part of training. RESULTS: One hundred five MT (1.6 MT per facility) conducted initial and refresher HBB trainings for 835 BAs; 76% had no prior resuscitation training. Initial training improved knowledge and skills: the pass percentage for knowledge tests improved from 74 to 99% (p < 0.001). Only 5% could ventilate a newborn mannequin correctly before initial training but 97% passed the post-initial ventilation training test (p < 0.0001) and 99% passed the OSCE B resuscitation evaluation. During pre-refresher training evaluation, a mean of 6.7 (SD 2.49) months after the initial training, 99% passed the knowledge test, but the successful completion rate fell to 81% for the OSCE B resuscitation skills test. Characteristics associated with deterioration of resuscitation skills were BAs from tertiary care facilities, no prior resuscitation training, and the timing of training (initial vs. catch-up training). CONCLUSIONS: HBB training significantly improved neonatal resuscitation knowledge and skills. However, skills declined more than knowledge over time. Ongoing skills practice and monitoring, more frequent retesting, and refresher trainings are needed to maintain neonatal resuscitation skills. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01681017; 04 September 2012, retrospectively registered. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12884-016-1141-3) contains supplementary material, which is available to authorized users.
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spelling pubmed-51204762016-11-28 Helping Babies Breathe (HBB) training: What happens to knowledge and skills over time? Bang, Akash Patel, Archana Bellad, Roopa Gisore, Peter Goudar, Shivaprasad S. Esamai, Fabian Liechty, Edward A. Meleth, Sreelatha Goco, Norman Niermeyer, Susan Keenan, William Kamath-Rayne, Beena D. Little, George A. Clarke, Susan B. Flanagan, Victoria A. Bucher, Sherri Jain, Manish Mujawar, Nilofer Jain, Vinita Rukunga, Janet Mahantshetti, Niranjana Dhaded, Sangappa Bhandankar, Manisha McClure, Elizabeth M. Carlo, Waldemar A. Wright, Linda L. Hibberd, Patricia L. BMC Pregnancy Childbirth Research Article BACKGROUND: The first minutes after birth are critical to reducing neonatal mortality. Helping Babies Breathe (HBB) is a simulation-based neonatal resuscitation program for low resource settings. We studied the impact of initial HBB training followed by refresher training on the knowledge and skills of the birth attendants in facilities. METHODS: We conducted HBB trainings in 71 facilities in the NICHD Global Network research sites (Nagpur and Belgaum, India and Eldoret, Kenya), with a 6:1 ratio of facility trainees to Master Trainers (MT). Because of staff turnover, some birth attendants (BA) were trained as they joined the delivery room staff, after the initial training was completed (catch-up initial training). We compared pass rates for skills and knowledge pre- and post- initial HBB training and following refresher training among active BAs. An Objective Structured Clinical Examination (OSCE) B tested resuscitation skill retention by comparing post-initial training performance with pre-refresher training performance. We identified factors associated with loss of skills in pre-refresher training performance using multivariable logistic regression analysis. Daily bag and mask ventilation practice, equipment checks and supportive supervision were stressed as part of training. RESULTS: One hundred five MT (1.6 MT per facility) conducted initial and refresher HBB trainings for 835 BAs; 76% had no prior resuscitation training. Initial training improved knowledge and skills: the pass percentage for knowledge tests improved from 74 to 99% (p < 0.001). Only 5% could ventilate a newborn mannequin correctly before initial training but 97% passed the post-initial ventilation training test (p < 0.0001) and 99% passed the OSCE B resuscitation evaluation. During pre-refresher training evaluation, a mean of 6.7 (SD 2.49) months after the initial training, 99% passed the knowledge test, but the successful completion rate fell to 81% for the OSCE B resuscitation skills test. Characteristics associated with deterioration of resuscitation skills were BAs from tertiary care facilities, no prior resuscitation training, and the timing of training (initial vs. catch-up training). CONCLUSIONS: HBB training significantly improved neonatal resuscitation knowledge and skills. However, skills declined more than knowledge over time. Ongoing skills practice and monitoring, more frequent retesting, and refresher trainings are needed to maintain neonatal resuscitation skills. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01681017; 04 September 2012, retrospectively registered. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12884-016-1141-3) contains supplementary material, which is available to authorized users. BioMed Central 2016-11-22 /pmc/articles/PMC5120476/ /pubmed/27875999 http://dx.doi.org/10.1186/s12884-016-1141-3 Text en © The Author(s). 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Bang, Akash
Patel, Archana
Bellad, Roopa
Gisore, Peter
Goudar, Shivaprasad S.
Esamai, Fabian
Liechty, Edward A.
Meleth, Sreelatha
Goco, Norman
Niermeyer, Susan
Keenan, William
Kamath-Rayne, Beena D.
Little, George A.
Clarke, Susan B.
Flanagan, Victoria A.
Bucher, Sherri
Jain, Manish
Mujawar, Nilofer
Jain, Vinita
Rukunga, Janet
Mahantshetti, Niranjana
Dhaded, Sangappa
Bhandankar, Manisha
McClure, Elizabeth M.
Carlo, Waldemar A.
Wright, Linda L.
Hibberd, Patricia L.
Helping Babies Breathe (HBB) training: What happens to knowledge and skills over time?
title Helping Babies Breathe (HBB) training: What happens to knowledge and skills over time?
title_full Helping Babies Breathe (HBB) training: What happens to knowledge and skills over time?
title_fullStr Helping Babies Breathe (HBB) training: What happens to knowledge and skills over time?
title_full_unstemmed Helping Babies Breathe (HBB) training: What happens to knowledge and skills over time?
title_short Helping Babies Breathe (HBB) training: What happens to knowledge and skills over time?
title_sort helping babies breathe (hbb) training: what happens to knowledge and skills over time?
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5120476/
https://www.ncbi.nlm.nih.gov/pubmed/27875999
http://dx.doi.org/10.1186/s12884-016-1141-3
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