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Aims To establish an innovative web-based COVID adapted Neonatal Resuscitation Workshop (CaNRW) which provides regular Simulation Based Education in neonatal resuscitation to meet service need and training demand and at the same time satisfy strict infection control measures imposed on classroom simulation based training in a regional hospital with delivery of 6000 per annum during COVID-19 outbreak in Hong Kong since 2021. Methods A CaNRW was developed with the Multi-Disciplinary Simulation and Skills Centre (MDSSC) in January 21. It consists of a 1-hour lecture delivered in YouTube;a 1- hour video on skills recommended by Neonatal Resuscitation Program of American Academy of Pediatrics and a real time birth related drill performed at MDSSC- Pict 1. All trainees participate it online except those involved in the drill. All providers can join the drill and debriefing online simultaneously. Upon competition, they were asked to complete an evaluation. Results Total 113 providers consisting of pediatric and emergency department residents, neonatal nurses and midwives joined three CaNRW in 2021. Providers didn't report difficulties in viewing the program through electronic devices. Program facilitators felt more comfortable in executing this CaNRW. Seventy-three evaluations were analyzed. The providers reported this CaNRW was useful with high level of satisfaction (Score:4.41/5). They strongly recommended it to colleagues (Score:8.53/10). Nurses and midwives were granted continuous nursing education credits (figure 1). Conclusion Our data data shows that this web-based innovative CaNRW is feasible and well accepted by trainees. It provides regular neonatal resuscitation training and satisfies strict infection control measures imposed on classroom simulation based training amidst of COVID outbreak in a regional hospital in Hong Kong since 2021. Both neonatal nurses and midwives gained training credits to fulfill their continuous professional education. Therefore, this mode of web-based CaNRW worth promoting and should be made available to more trainees and departments in hospitals where strict infection control measures for classroom teaching is in place amidst of COVID- 19 Outbreak.. (Figure Presented).
ABSTRACT
Background: A good and effect iveneonatal resuscitation training (NRT) program is important for retaining skills and achieving good outcome. A stimulation based Neonatal Resuscitation Workshop (NRW) has been held quarterly for Paediatric, Obstetric and Emergency Department trainees since 2011. The NRW was suspended since July 20 due to COVID-19 pandemic. A web-based COVID-adapted NRW (CaNRW) was developed in January 21 to achieve the objectives of providing NRT and abiding infection control measures. Methods: A CaNRW was developed with the Multi- Disciplinary Simulation and Skills Centre (MDSSC), Queen Elizabeth Hospital in January 21. It consists of a 1- hour lecture delivered in YouTube;a 1- hour video on skills and a birth related drill performed at MDSSC. All trainees participate it online except those involved in the drill. Trainees can join the drill and debriefing online simultaneously. Upon competition, they were asked to complete an evaluation. Results: Total 113 trainees joined three CaNRW in 21. Trainees didn't report difficulties in viewing. Facilitators felt more comfortable in executing this CaNRW. Seventythree evaluations were analysed. Trainees reported this CaNRW was useful with high level of satisfaction (Score: 4.41/5). Trainees strongly recommended it to their colleagues (Score: 8.53/10). Nurses and midwives were granted Continuous Nursing Education and PEM credits respectively. Conclusions: This innovative web-based CaNRW provides a simple and structured model for NRT during COVID-19 pandemic. Trainees welcomed and enjoyed it. Thus, this CaNRW is worth promoting and should be made available to more trainees and departments. More studies should be performed to testify its clinical values.
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Background: Nowadays, noninvasive ventilation is the mainstay of the ventilation strategy in the neonatal intensive care units (NICUs) and most of infants, especially preterm infants, having respiratory problems, are provided noninvasive ventilation (NIV) upon their demands. Nevertheless, complication of NIV device-related pressure injury was common, the incidence of nasal injury ranged from 20% to 60%. Limited studies were found evaluating the nursing care of preterm infants receiving NIV. Aims: This study aimed to develop an evidence-based clinical practice guideline for preterm infants receiving NIV, implement the guideline in a NICU of a regional hospital, and evaluate infant outcomes including comfort, incidence of NIV device-related pressure injury. Besides, improvement on nurse's knowledge and practice for caring infants under NIV were assessed. Study Design and Methods: The Iowa Model-Revised was adopted as the theoretical framework to guide the study process. A multidisciplinary workgroup consists of eight stakeholders in NICU was formed for the process and acted as the champions for the new practice. A before and after study design was adopted and included the preimplementation and post-implementation phases. An integrative review was conducted to identify relevant studies from eight electronic databases before the study. All eligible studies were appraised using the Johns Hopkins University's evidence appraisal tool. Neonatal Pain, Agitation and Sedation Scale (N-PASS) for pain assessment and two self-developed NIV care bundle knowledge test and audit tool were used for the study. Results: Due to the COVID-19 pandemic in 2020, the study was extended for a month and ended in January 2021. A total of 74 infants in Pre-implementation phase (before group) and 67 infants in Post-implementation phase (after group) were recruited. Logistic regression model was used to compare the incidence of pressure injury between groups after adjusted for all substantial covariates in the study. Infants in after group had an 84% decreased odds of acquiring pressure injury (adjusted OR=0.149, 95% CI 0.045-0.495, p=0.002). Infant's comfort level whilst receiving NIV was not determined in the study as the after group having a significantly lesser mean time (p<0.001) in calm state but lower N-PASS score. Regarding nurse participants, 71 nurses received the training programme on NIV care bundle, and overall nurses' knowledge level improved immediately (adjusted p<0.001) and at 12 weeks after the programme. Three audits were conducted to evaluate nurses' practice, nurses' compliance rate to the care bundle significantly improved at 12 (p<0.001) and 24 weeks (p<0.001) in comparison with baseline compliance rate in the pre-implementation phase. However, nurses' knowledge retention at 12-week and compliance rate at 24-week after the training programme declined. Conclusion: The evidence-based clinical practice guideline aims to promote comfort and prevent injury in infants receiving NIV, and outcomes of the infants depend on vigilant nursing care and compliance to this clinical practice guideline. Declining of nurse's knowledge level and practice compliance found in the study indicates the needs of continuous education and audit on the practice to sustain the service quality and patient's safety.
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This work is reporting the advocation of a public Malaysia University for the environmental protection through sustainable waste practices ever since its ban on the use of the "White Coffin " initiative in circa 2008, a flagship for environmental activism on its different campuses targeting to get rid of polystyrene containers. This initiative was not halted but served as a spark of flare for a sustainability journey up to this very day. The effort to realise a sustainable tomorrow as the vision of higher education sector, including the studied Malaysian University has been integrating efforts from various parties. This includes the formation of "Kampus Sejahtera " (wellness campus), regional centre of expertise, sustainability course, and more recently the sustainability month, sustainability network, and most importantly, the local NGO-industrial-academia collaboration in the path toward a sustainable tomorrow. The work in this article delineates a case study in implementing sustainable waste practice from the start to the status, in one of the Malaysian public universities which is ranked 39th in Times Higher Education University in Global Impact Ranking 2021, and top in Malaysia. More emphasis will be placed on the current initiative of the local NGO-industrial-academia collaboration as case study in the midst of the COVID-19 pandemic.