Academic Journal
View in EDS

Frequent refresher training on newborn resuscitation and potential impact on perinatal outcome over time in a rural Tanzanian hospital: an observational study

Bibliographic Details
Title: Frequent refresher training on newborn resuscitation and potential impact on perinatal outcome over time in a rural Tanzanian hospital: an observational study
Authors: Jan Terje Kvaløy, Hege Langli Ersdal, Estomih Mduma, Eldar Soreide, Erling Svensen, Paschal Mdoe, Jeffrey Perlman, Caroline Johnson, Hussein Lessio Kidanto
Source: BMJ Open, Vol 9, Iss 9 (2019)
Publisher Information: BMJ Publishing Group, 2019.
Publication Year: 2019
Collection: LCC:Medicine
Subject Terms: Medicine
More Details: Objectives Globally, perinatal mortality remains high, especially in sub-Saharan countries, mainly because of inadequate obstetric and newborn care. Helping Babies Breathe (HBB) resuscitation training as part of a continuous quality improvement (CQI) programme may improve outcomes. The aim of this study was to describe observed changes in perinatal survival during a 6-year period, while adjusting for relevant perinatal risk factors.Setting Delivery rooms and operating theatre in a rural referral hospital in northern-central Tanzania providing comprehensive obstetric and basic newborn care 24 hours a day. The hospital serves approximately 2 million people comprising low social-economic status.Participants All newborns (n=31 122) born in the hospital from February 2010 through January 2017; 4893 were born in the 1-year baseline period (February 2010 through January 2011), 26 229 in the following CQI period.Interventions The HBB CQI project, including frequent HBB training, was implemented from February 2011. This is a quality assessment analysis of prospectively collected observational data including patient, process and outcome measures of every delivery. Logistic regression modelling was used to construct risk-adjusted variable life adjusted display (VLAD) and cumulative sum (CUSUM) plots to monitor changes in perinatal survival (primary outcome).Results During the 6-year CQI period, the unadjusted number of extra lives saved according to the VLAD plot was 150 despite more women admitted with pregnancy and labour complications and more caesarean deliveries. After adjusting for these risk factors, the risk-adjusted VLAD plot indicated that an estimated 250 extra lives were saved. The risk-adjusted CUSUM plot confirmed a persistent and steady increase in perinatal survival.Conclusions The risk-adjusted statistical process control methods indicate significant improvement in perinatal survival after initiation of the HBB CQI project with continuous focus on newborn resuscitation training during the period, despite a concomitant increase in high-risk deliveries. Risk-adjusted VLAD and CUSUM are useful methods to quantify, illustrate and demonstrate persistent changes in outcome over time.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2044-6055
Relation: https://bmjopen.bmj.com/content/9/9/e030572.full; https://doaj.org/toc/2044-6055
DOI: 10.1136/bmjopen-2019-030572
Access URL: https://doaj.org/article/665583e09cb44cb1a59b787c7ddcadfa
Accession Number: edsdoj.665583e09cb44cb1a59b787c7ddcadfa
Database: Directory of Open Access Journals
FullText Text:
  Availability: 0
CustomLinks:
  – Url: https://resolver.ebsco.com/c/xy5jbn/result?sid=EBSCO:edsdoj&genre=article&issn=20446055&ISBN=&volume=9&issue=9&date=20190901&spage=&pages=&title=BMJ Open&atitle=Frequent%20refresher%20training%20on%20newborn%20resuscitation%20and%20potential%20impact%20on%20perinatal%20outcome%20over%20time%20in%20a%20rural%20Tanzanian%20hospital%3A%20an%20observational%20study&aulast=Jan%20Terje%20Kval%C3%B8y&id=DOI:10.1136/bmjopen-2019-030572
    Name: Full Text Finder (for New FTF UI) (s8985755)
    Category: fullText
    Text: Find It @ SCU Libraries
    MouseOverText: Find It @ SCU Libraries
  – Url: https://doaj.org/article/665583e09cb44cb1a59b787c7ddcadfa
    Name: EDS - DOAJ (s8985755)
    Category: fullText
    Text: View record from DOAJ
    MouseOverText: View record from DOAJ
Header DbId: edsdoj
DbLabel: Directory of Open Access Journals
An: edsdoj.665583e09cb44cb1a59b787c7ddcadfa
RelevancyScore: 904
AccessLevel: 3
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 903.794311523438
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: Frequent refresher training on newborn resuscitation and potential impact on perinatal outcome over time in a rural Tanzanian hospital: an observational study
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Jan+Terje+Kvaløy%22">Jan Terje Kvaløy</searchLink><br /><searchLink fieldCode="AR" term="%22Hege+Langli+Ersdal%22">Hege Langli Ersdal</searchLink><br /><searchLink fieldCode="AR" term="%22Estomih+Mduma%22">Estomih Mduma</searchLink><br /><searchLink fieldCode="AR" term="%22Eldar+Soreide%22">Eldar Soreide</searchLink><br /><searchLink fieldCode="AR" term="%22Erling+Svensen%22">Erling Svensen</searchLink><br /><searchLink fieldCode="AR" term="%22Paschal+Mdoe%22">Paschal Mdoe</searchLink><br /><searchLink fieldCode="AR" term="%22Jeffrey+Perlman%22">Jeffrey Perlman</searchLink><br /><searchLink fieldCode="AR" term="%22Caroline+Johnson%22">Caroline Johnson</searchLink><br /><searchLink fieldCode="AR" term="%22Hussein+Lessio+Kidanto%22">Hussein Lessio Kidanto</searchLink>
– Name: TitleSource
  Label: Source
  Group: Src
  Data: BMJ Open, Vol 9, Iss 9 (2019)
– Name: Publisher
  Label: Publisher Information
  Group: PubInfo
  Data: BMJ Publishing Group, 2019.
– Name: DatePubCY
  Label: Publication Year
  Group: Date
  Data: 2019
– Name: Subset
  Label: Collection
  Group: HoldingsInfo
  Data: LCC:Medicine
– Name: Subject
  Label: Subject Terms
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Medicine%22">Medicine</searchLink>
– Name: Abstract
  Label: Description
  Group: Ab
  Data: Objectives Globally, perinatal mortality remains high, especially in sub-Saharan countries, mainly because of inadequate obstetric and newborn care. Helping Babies Breathe (HBB) resuscitation training as part of a continuous quality improvement (CQI) programme may improve outcomes. The aim of this study was to describe observed changes in perinatal survival during a 6-year period, while adjusting for relevant perinatal risk factors.Setting Delivery rooms and operating theatre in a rural referral hospital in northern-central Tanzania providing comprehensive obstetric and basic newborn care 24 hours a day. The hospital serves approximately 2 million people comprising low social-economic status.Participants All newborns (n=31 122) born in the hospital from February 2010 through January 2017; 4893 were born in the 1-year baseline period (February 2010 through January 2011), 26 229 in the following CQI period.Interventions The HBB CQI project, including frequent HBB training, was implemented from February 2011. This is a quality assessment analysis of prospectively collected observational data including patient, process and outcome measures of every delivery. Logistic regression modelling was used to construct risk-adjusted variable life adjusted display (VLAD) and cumulative sum (CUSUM) plots to monitor changes in perinatal survival (primary outcome).Results During the 6-year CQI period, the unadjusted number of extra lives saved according to the VLAD plot was 150 despite more women admitted with pregnancy and labour complications and more caesarean deliveries. After adjusting for these risk factors, the risk-adjusted VLAD plot indicated that an estimated 250 extra lives were saved. The risk-adjusted CUSUM plot confirmed a persistent and steady increase in perinatal survival.Conclusions The risk-adjusted statistical process control methods indicate significant improvement in perinatal survival after initiation of the HBB CQI project with continuous focus on newborn resuscitation training during the period, despite a concomitant increase in high-risk deliveries. Risk-adjusted VLAD and CUSUM are useful methods to quantify, illustrate and demonstrate persistent changes in outcome over time.
– Name: TypeDocument
  Label: Document Type
  Group: TypDoc
  Data: article
– Name: Format
  Label: File Description
  Group: SrcInfo
  Data: electronic resource
– Name: Language
  Label: Language
  Group: Lang
  Data: English
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 2044-6055
– Name: NoteTitleSource
  Label: Relation
  Group: SrcInfo
  Data: https://bmjopen.bmj.com/content/9/9/e030572.full; https://doaj.org/toc/2044-6055
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1136/bmjopen-2019-030572
– Name: URL
  Label: Access URL
  Group: URL
  Data: <link linkTarget="URL" linkTerm="https://doaj.org/article/665583e09cb44cb1a59b787c7ddcadfa" linkWindow="_blank">https://doaj.org/article/665583e09cb44cb1a59b787c7ddcadfa</link>
– Name: AN
  Label: Accession Number
  Group: ID
  Data: edsdoj.665583e09cb44cb1a59b787c7ddcadfa
PLink https://login.libproxy.scu.edu/login?url=https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&scope=site&db=edsdoj&AN=edsdoj.665583e09cb44cb1a59b787c7ddcadfa
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1136/bmjopen-2019-030572
    Languages:
      – Text: English
    Subjects:
      – SubjectFull: Medicine
        Type: general
    Titles:
      – TitleFull: Frequent refresher training on newborn resuscitation and potential impact on perinatal outcome over time in a rural Tanzanian hospital: an observational study
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Jan Terje Kvaløy
      – PersonEntity:
          Name:
            NameFull: Hege Langli Ersdal
      – PersonEntity:
          Name:
            NameFull: Estomih Mduma
      – PersonEntity:
          Name:
            NameFull: Eldar Soreide
      – PersonEntity:
          Name:
            NameFull: Erling Svensen
      – PersonEntity:
          Name:
            NameFull: Paschal Mdoe
      – PersonEntity:
          Name:
            NameFull: Jeffrey Perlman
      – PersonEntity:
          Name:
            NameFull: Caroline Johnson
      – PersonEntity:
          Name:
            NameFull: Hussein Lessio Kidanto
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 09
              Type: published
              Y: 2019
          Identifiers:
            – Type: issn-print
              Value: 20446055
          Numbering:
            – Type: volume
              Value: 9
            – Type: issue
              Value: 9
          Titles:
            – TitleFull: BMJ Open
              Type: main
ResultId 1