The Helping Babies Survive Programs: Educational Programs to Improve Neonatal Outcomes 2015 NRP® Current Issues Seminar.

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Presentation transcript:

The Helping Babies Survive Programs: Educational Programs to Improve Neonatal Outcomes 2015 NRP® Current Issues Seminar

Faculty Disclosures Carl Bose, MD, FAAP & Nalini Singhal, MD, FAAP have no relevant disclosures

Global Neonatal Health Most of these deaths are preventable! 3.8 neonatal deaths (3.2 million stillbirths) ~ 3x deaths due to HIV/AIDs and malaria combined > 400 neonatal deaths each hour

Where do most neonatal deaths occur? Oestergaard et al. PLoS Med 2011

What Causes Neonatal Death?

What can be done? Improved resuscitation Preterm labor management KMC Alternate feeding techniques Cord care Improved hygiene Exclusive breastfeeding

EDUCATIONAL DESIGN SIMPLEHANDS ONCO-OPERATIVE LEARNING

EDUCATIONAL DESIGN PURPOSEFUL DEVELOPMENT OF EDUCATIONAL MODELS Bag and Mask Ventilation Expression breast milkNasogastric tube feeding

EDUCATIONAL DESIGN ONGOING PROFESSIONAL DEVELOPMENT: Suggestions for practice Ability to practice with partners as modeled in the course Low cost simulators for practice IMPLEMENTATION OF CHANGE: How to start What to monitor Possible options for change

Helping Babies Breathe (HBB) Action Plan

Facilitator Flip Chart Learner Workbook Neonatal Simulator Bag and Mask Suction Device Helping Babies Breathe Materials

Change in Skills but not Practice: Observations at Haydom Hospital, Tanzania Sept 2009Nov 2010 Scenario (video analysis) N= 39N=27 Routine care (% pass)4174* Bag-mask (% pass)1874^ Delivery room (observation) N=2745N=3116 Stimulation (%) * BMV (%) Time to BMV (sec) * * p<0.05 ^ p< Ersdal HL et al. Resuscitation 2013; 84:1422 April 2010 HBB training

Msemo G et al. Pediatrics 2013; 131:e353

Impact of Low-Dose, High-Frequency Practice: Haydom Hospital, Tanzania Sept 2009Nov 2010Feb Jan 2011 Feb Jan 2012 Clinical interventions Fresh stillbirth (per 1000 live births) * Death < 24 hours (per 1000 live births) * Delivery room (obs)N=2745N=3116N=4876N=4734 Stimulation (%) * * BMV (%) Time to BMV (%) * * p < p =0.03Ersdal HL et al. Resuscitation 2013; 84:1422 April 2010 HBB trainingFebruary 2011 LDHF practice

Essential Care for Every Baby (ECEB) Action Plan

Facilitator Flipchart Provider Guide Parent Guide Essential Care for Every Baby Materials

Essential Care for Every Baby Parent Guide

Field Testing MCQ Pre 19.4/26 Post 25.2/26 Confidence Pre 3.2/5 Post 4.6/5

Essential Care for Small Babies (ECSB) Action Plan

Facilitator Flipchart Provider Guide Parent Guide Essential Care for Small Babies Materials

Expression of Breast Milk

Nasogastric Tube Feeding

Improved resuscitation Cord care Improved hygiene Exclusive breastfeeding The Helping Babies Survive Programs Preterm labor management KMC Alternate feeding techniques

The Formula for Survival Utopia 100% x 100% x 100% = 100% Ideal? 90% x 90% x 90% = 72% Actual? 80% x 50% x 50% = 20% Patient survival the result of three equally important factors Ref: Søreide et al. The formula for survival in resuscitation. Resuscitation 2013;84: Medical Science Educational Efficiency Local Implementation Survival

Sample Page from the Provider Guide Monitor Key Indicators Quality Improvement Strategies

THANK YOU! Help babies breath if they do not cry at birth. Provide essential care to all babies. Keep small babies well and help them grow.