Air, air, air: a champion midwife programme in Tanzania using HOT neonatal resuscitation - lessons learned

Article


Becker, Jan, Wu, Chiung-Jung (Jo), Becker, Chase, Moir, James, Gray, Marion, Shimwela, Meshak and Oprescu, Florin. 2022. "Air, air, air: a champion midwife programme in Tanzania using HOT neonatal resuscitation - lessons learned." Transactions of the Royal Society of Tropical Medicine and Hygiene. 116 (5), pp. 375-380. https://doi.org/10.1093/trstmh/trab154
Article Title

Air, air, air: a champion midwife programme in Tanzania using HOT neonatal resuscitation - lessons learned

ERA Journal ID13807
Article CategoryArticle
AuthorsBecker, Jan (Author), Wu, Chiung-Jung (Jo) (Author), Becker, Chase (Author), Moir, James (Author), Gray, Marion (Author), Shimwela, Meshak (Author) and Oprescu, Florin (Author)
Journal TitleTransactions of the Royal Society of Tropical Medicine and Hygiene
Journal Citation116 (5), pp. 375-380
Number of Pages6
Year2022
Place of PublicationUnited Kingdom
ISSN0035-9203
Digital Object Identifier (DOI)https://doi.org/10.1093/trstmh/trab154
Web Address (URL)https://academic.oup.com/trstmh/advance-article/doi/10.1093/trstmh/trab154/6382412
Abstract

Background: Tanzania has approximately 40 000 newborn deaths per year, with >25% of these linked to intrapartum-related hypoxia. The Helping Babies Breathe© and Golden minute© (HBB©) programme was developed to teach skilled intervention for non-breathing neonates at birth. While Helping Babies Breathe© and Golden minute©, providing training in simulated bag and mask ventilation, is theoretically successful in the classroom, it often fails to transfer to clinical practice without further support. Furthermore, the proclivity of midwives to suction excessively as a first-line intervention is an ingrained behaviour that delays ventilation, contributing to very early neonatal deaths.

Methods: The ‘champion’ programme provided guided instruction during a real-life resuscitation. The site was Amana Hospital, Tanzania. The labour ward conducts 13 500 deliveries annually, most of which are managed by midwives. Brief mannikin simulation practice was held two to three times a week followed by bedside hands-on training (HOT) of bag and mask skills and problem solving while reinforcing the mantra of ‘air, air, air’ as the first-line intervention during a real-life emergency.

Results: Champion midwives (trainers) guided instructions given during a real emergency at the bedside caused learners beliefs to change. Trainees observed changes in baby skin colour and the onset of spontaneous breathing after effective ventilation.

Conclusions: Visible success during an actual real-life emergency created confidence, mastery and collective self-efficacy.

Keywordscollective self-efficacy, midwife, neonatal resuscitation, training, transferring clinical skills
ANZSRC Field of Research 2020420401. Clinical midwifery
Byline AffiliationsUniversity of the Sunshine Coast
University of Nicosia, Cyprus
Nucleus Medical Suites, Australia
School of Health and Wellbeing
Temeke Regional Referral Hospital, Tanzania
Institution of OriginUniversity of Southern Queensland
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