Continuous Training and Certification in Neonatal Resuscitation in Remote Areas Using a Multi-platform Information and Communication Technology Intervention Compared to Standard Training: A Randomized Cluster Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 12
- 试验地点
- 2
- 主要终点
- Heart rate at two minutes of life
研究概览
简要总结
Background: About 10% of all newborns may have difficulty breathing and require support by trained personnel. In Peru, 90% of deliveries occur in health facilities; however there is not a national neonatal resuscitation and certification program for the public health sector. In addition, the Andes and the Amazon regions concentrate large rural remote areas, which further limit the implementation of training programs and the accomplishment of continuous certification. Neonatal resuscitation training through the use of information, communication and technology (ICT) tools running on a computer, tablet or mobile phone may overcome such limitations. This strategy allows online and offline access to educational resources, paving the way to more frequent and efficient training and certification processes.
Objective: To evaluate the effects of a neonatal resuscitation training and certification program that uses a multi-platform ICT (MP-ICT) strategy on neonatal health care in remote areas.
Methods: The investigators propose to conduct the study through a cluster-randomized trial, where the study and analysis units are the health care facility. Eligible facilities will include primary and secondary health care level facilities that are located in provinces with neonatal mortality rates higher than 15 per 1,000 live births. The investigators will compare the proportion of newborns with a heart rate ≥100 beats per minute at 2 minutes after birth in health care facilities that receive MP-ICT training and certification implementation, with those that receive conventional training and certification.
Discussion: The investigators expect that the intervention show to be more effective than the current standard of care. The investigators are prepared to include it within a national neonatal resuscitation training and certification program to be implemented at national scale together with policymakers and other key stakeholders.
详细描述
Background
A training system using Multi-platform ICT (MP-ICT) tools offers reliable and easier access to information and training packages from different locations which can be implemented even in rural settings without access to internet. Platforms may be available online, and users can download the training content through a personal computer, a tablet or a mobile phone. The training content may be downloaded repeatedly afterwards, even in remote areas without access to internet.
Our project aims to evaluate the performance of a continuous process of training and certification in neonatal resuscitation in primary and secondary health facilities in the departments of Ayacucho and Cusco, through the use of MP-ICT tools. It aims at providing proof of concept of the interventions, which then could be expected to be incorporated as a component of a national neonatal resuscitation program to be implemented nationwide.
The traditional way to train and certify health care professionals is through administration of a theoretical expositive course, reinforced subsequently by a practical component. This modality requires face-to-face contact between trainers and trainees. Health workers need to move from their job site to the instruction sites, usually located in the capital city of the department or in the capital city of the country. This poses economic and logistic challenges to both health authorities and health workers, and results in erratic frequency and low uptake of training courses.
Research hypothesis
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Primary and secondary level facilities located in Ayacucho and Cusco that have a neonatal mortality rate higher than 15 per 1,000 livebirths will be eligible
排除标准
- •Health facilities whose authorities refuse participation of their health professionals, facilities with less than 290 births a year, facilities located at more than 210 kilometres from the department capital and those located in high risk areas due to social unrest will be excluded
研究组 & 干预措施
Standard Neonatal Resuscitation Training
Standard training will be conducted through a theoretical-practical course, which will be administered once during the study period, to all health professionals of the selected facilities, according to the randomization. It is an 8-hour course, with 3 hours of theory and 5 hours of practice, which will take place during a single day. The course will be performed by staff of the Neonatal Unit of the Instituto Nacional de Salud del Niño (National Institute of Child Health, Lima, Peru), and will be coordinated by an NRP instructor accredited by the American Academy of Pediatrics. Participants who have completed their attendance to theoretical sessions, participated in the simulated practices and approved the printed exams taken the same day will we granted a Standard Certification.
干预措施: Standard Neonatal Resuscitation Training (Behavioral)
MP-ICT Neonatal Resuscitation Training
The Multi-platform ICT (MP-ICT) training includes continuous certification in neonatal resuscitation and is being developed for online and offline access, and will be complemented with simulated practices on every site. The platform is being improved and adjusted to the needs of the fieldwork in Ayacucho and Cusco. The adaptations include increasing hosting; ameliorate friendly usability, uploading packages and videos, improvement of examination and certifications, and tests for readiness. The MP-ICT resource will be accessed from remote Peruvian locations through computers, personal portable devices and cell phones. To be granted an MP-ICT Certification the trainee needs to have passed the online theoretical exam, assist to the practice and approve practical skills assessment.
干预措施: MP-ICT Neonatal Resuscitation Training (Behavioral)
结局指标
主要结局
Heart rate at two minutes of life
时间窗: Up to six months
Percentage of infants with heart rate equal or greater than 100 per minute at 2 minutes of life.
次要结局
- Starting positive pressure ventilation(Up to six months)
- Certified NRP providers(Up to six months)
- Certified NRP instructors(Up to six months)
- Heart rate >= 100 bpm(Up to six months)
- Oxygen requirement at 10 minutes(Up to six months)
- Oxygen requirement at 30 minutes(Up to six months)
- Early neonatal referral(Up to six months)
- Apgar(Up to six months)
- Early neonatal mortality(Up to six months)