ABSTRACT
Background: Use of simulation-based learning methodologies enhance performance in both simulated resuscitations and real-life clinical situations. Retention of skill is very important for the MBBS doctors who hardly get any exposure to such learning before entering post-graduate courses. The major cause of early neonatal death is neonatal asphyxia, which can be prevented by neonatal resuscitation. Effective resuscitation at birth can prevent neonatal deaths to a greater extent. Training in cardio-pulmonary resuscitation is critical in determining successful outcomes in perinatal asphyxia. Hence the present study was done to check the retention of knowledge after Neonatal Resuscitation Program (NRP ) training. Methods: A prospective interventional study was carried out among the MBBS interns who started their internship program from March 2020 - February 2021 in ACSR Government Medical College, Nellore. All the Interns were given training in NRP as a part of internship orientation programme during the first week of internship. Out of 150 interns, 143 participated in the study. The interns were oriented to the study and a pretest questionnaire was administered to them to assess their knowledge and skill regarding NRP which was followed by NRP training by the faculty of pediatrics and neonatology. The same questionnaire was administered immediately at the end of the training, 1 and 6 months post NRP training for assessing their knowledge and skill. Results: As compared to pre intervention score, the mean scores of the immediate post intervention score and at 1 month after intervention the mean score was increased with respect to knowledge and skills. After 6 months the mean scores pertaining to knowledge and skill decreased which were statistically significant. Conclusions: A significant decrease in the level of knowledge and skills regarding neonatal resuscitation was observed. Therefore, maintaining resuscitation skill requires continuous practice, supplemented by simulation training as needed.
ABSTRACT
Background: India contributes to 25% of neonatal mortality around the world. In developing countries neonatal mortality is quite high despite of advances in perinatal and neonatal care. The establishment of Special Newborn Care Units (SNCU) has been quite essential in reducing the neonatal morbidity and mortality. This study was conducted to assess the outcome of SNCU at a newly commissioned tertiary care teaching hospital at Nellore District, Andhra Pradesh. Aim of this study the morbidity and mortality patterns in an SNCU at tertiary care teaching hospital.Methods: It was a Retrospective, Hospital based, Descriptive study which was done among neonates admitted to SNCU, Nellore District, Andhra Pradesh for a period of 1 year (January 2015-December 2015). All the neonates admitted to SNCU, Nellore District, Andhra Pradesh during the study period were included in the study. Data was recorded in a predesigned semi-structured proforma. the data was entered into excel-sheet and analyzed using SPSS software version 21.Results: A total of 1015 babies were included in the study. Almost half 592(58.32%) were born in this hospital(inborn) and 423(41.67%) babies were referred from peripheral hospitals and nursing homes (out born). about 3/4th 767(75.5%) of babies were admitted in the first 24 hours of life. Almost half (53.4%) of the study group were male and 46.6% were female. The chief causes of admission in SNCU were Respiratory Distress Syndrome (40.2%) followed by birth asphyxia (19.1%), sepsis (13.3%), Neonatal Jaundice (9.9%) and prematurity (6.6%). In our study 63.0% patients were discharged, 19.3% had left hospital against medical advice, 10.1% died and 7.6% were referred to other institutions for specialized treatment.Conclusion: Respiratory Distress Syndrome, neonatal sepsis, neonatal hyperbilirubinemia, and HIE as the major causes of morbidity. Low Birth Weight and prematurity were the commonest contributors of death, therefore, attempts to prolong the pregnancy each week might improve the neonatal outcome considerably.