Simulation and team training embedded nurse mentoring programme and improvement in intrapartum and newborn care in a low-resource setting in Bihar, India

Improvement of the quality of maternal and child health care remains a focus in India. Working with the Government of Bihar, CARE-India facilitated a comprehensive set of quality of care improvement initiatives. PRONTO's simulation and team-training was incorporated into the large-scale (AMANAT...

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Vydané v:Journal of global health Ročník 10; číslo 2; s. 021010
Hlavní autori: Ghosh, Rakesh, Spindler, Hilary, Dyer, Jessica, Christmas, Amelia, Cohen, Susanna R, Das, Aritra, Sonthalia, Sunil, Mahapatra, Tanmay, Gore, Aboli, Shah, Hemant, Walker, Dilys M
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: Scotland Edinburgh University Global Health Society 01.12.2020
International Society of Global Health
Predmet:
Childbirth & labor
Childrens health
Communication
Curricula
Delivery, Obstetric
Evidence-based nursing
Female
Global health
Humans
India
Infant mortality
Infant, Newborn
Intervention
Maternal & child health
Maternal-Child Health Services
Mentoring
Mentors
Newborn babies
Nurses
Obstetrics
Pregnancy
Primary care
Public health
Public sector
Quality Improvement
Research Theme 6: Learning from Ananya Program in Bihar
Simulation
Teamwork
Training
Vagina
India
Bihar India
ISSN:2047-2978, 2047-2986, 2047-2986
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Shrnutí:Improvement of the quality of maternal and child health care remains a focus in India. Working with the Government of Bihar, CARE-India facilitated a comprehensive set of quality of care improvement initiatives. PRONTO's simulation and team-training was incorporated into the large-scale (AMANAT)nurse-mentoring program of the Government of Bihar supported by CARE-India to improve maternal and child health outcomes. Along-with the AMANAT program, the PRONTO components provided training on nontechnical and technical competencies for managing a variety of obstetric and neonatal conditions, as a team. This study assessed the effectiveness of nurse-mentoring including simulations on intrapartum and newborn care practices in 320 basic emergency obstetric and neonatal care (BEmONC) facilities. Deliveries were observed to obtain specific information on evidence-based practice (EBP) indicators before and after the intervention. Intrapartum and newborn care composite scores - were calculated using those EBP indicators. A web-based routine monitoring system provided total training days, weeks and days/week of training and counts of simulation and teamwork-communication activities. Multilevel linear regression was used to examine the exposure-outcome associations. The final analysis included 668 normal spontaneous vaginal deliveries (NSVDs) from 289 public health facilities in Bihar. Facility-level intrapartum and newborn scores improved by 37 and 26-percentage points, respectively, from baseline to endline. Compared to the bottom one-third facilities that performed fewest NSVD simulations, the top one-third had 6 (95% confidence interval (CI) = 1-12) percentage points higher intrapartum score. Similar comparison using maternal complication simulations yielded 7 (95% CI = 1-12) percentage point higher scores. The highest newborn scores were observed in the middle one-third of facilities relative to the bottom one-third that did the fewest NSVD simulations (5, 95% CI: 1-10). Findings suggest significant overall improvement in intrapartum and newborn care practices after the AMANAT nurse-mentoring program in public sector BEmONC facilities. Simulation and team-training likely contributed towards the overall improvement, especially for intrapartum care. ClinicalTrials.gov number NCT02726230.
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ISSN:2047-2978
2047-2986
2047-2986
DOI:10.7189/jogh.10.021010