WIP 03 - Essential Newborn Care 1 Implementation with Virtual Refreshers in Uzbekistan

Publication Number: WIP 03.7397

Pierre Kobierski, Children's Hospital Los Angeles, Los Angeles, CA, United States; Mark H. Corden, Children's Hospital Los Angeles, Los Angeles, CA, United States; Colleen Kraft, Keck School of Medicine of the University of Southern California, Los Angeles, CA, United States; N Charity Nguyen, Children's Hospital Los Angeles, Los Angeles, CA, United States

Background: Essential Newborn Care 1 (ENC1) is a hands-on educational program for birth attendants in resource-limited settings to learn basic neonatal resuscitation. Its impact on neonatal outcomes is well-established. However, knowledge and skill retention after initial training declines, with learners’ skills (e.g. bag mask ventilation) tending to deteriorate more than knowledge. Virtual refreshers for ENC training could expand reach and reduce costs. The optimal frequency and delivery of virtual refreshers remains unknown.

Objective: Our study aims to determine whether periodic virtual refresher training sessions for perinatal nurses in Uzbekistan can improve retention of resuscitation skills and/or enhance neonatal outcomes.

Design/Methods: For this IRB-approved, parallel cluster study, we enrolled eighty nurses from two perinatal hospitals in Uzbekistan. All nurses were trained in ENC1 in the traditional manner, and the hospitals were randomized to intervention and control arms. Nurses at the intervention site will participate in bi-monthly virtual refresher sessions for the next 6 months; nurses at the control site will not. Virtual sessions include didactic review and hands-on practice with personalized instruction. Learners will be asked to provide anonymous feedback so sessions can be refined to their needs.

At 6 months after initial training, knowledge and skills will be assessed with the standard ENC1 evaluations. We will compare results from each hospital to evaluate the intervention’s impact on knowledge and skill retention. We will also track data on neonatal outcomes at each hospital for a period from 6 months before to 6 months after the initial training to determine whether the intervention has any effects on clinical outcomes for neonates. This data includes presence of spontaneous respiration, time from birth to ventilation, ventilation duration, stillbirth rate, rate of hypoxemic ischemic encephalopathy at 1 week, and discharge destination. We will conduct a repeated measures ANOVA to examine the mean intervention differences at 6 months.