NSW Neonatal Resuscitation - training a state
Aim
To offer Neonatal Resuscitation training opportunities for all birthing services in NSW, to increase both confidence and competence.
Method
A Neonatologist from each of 8 tertiary level neonatal units has agreed to run 4 courses in a 2 year period. These courses will be provided free of charge to the participants. The tertiary units involved will be:
- John Hunter Children’s Hospital
- The Children’s Hospital at Westmead
- Canberra Hospital
- NETS
- Royal North Shore Hospital
- Nepean Hospital
- The Royal Hospital for Women
- Royal Prince Alfred
As Sydney Children’s Hospital has only limited neonatal ICU beds within their PICU and the hospital is co-located with The Royal Women’s Hospital which can provide the neonatal resuscitation program SCH has not been included in the program.
The Fetal welfare Obstetric emergency Neonatal resuscitation Training (FONT) includes a one day maternal emergency and neonatal resuscitation program and is mandatory for all NSW clinicians who care for newborns to attend every three years. The neonatal resuscitation component of this day involves a 90 minute education session and includes basic neonatal resuscitation skills. The proposed courses will involve a more extensive advanced neonatal resuscitation training program.
The courses will cover neonatal resuscitation, stabilisation of the newborn and interpretation of blood gases and x rays in both metropolitan and rural centres in NSW. The 32 courses will be strategically placed around NSW to attract medical, nursing and associated professionals from all services caring for newborn infants in NSW. Each course will be practical, interactive and relevant to their clinical practice and will offer skills including caring for sick newborn infants. Each course has been costed to cover accommodation, transport costs to and from venues and coordinators home town and food and beverage for the trainers. The 1 day/2 day session will be interactive and have an agreed format for each centre. The numbers of attendees will depend on coordinator preference but will generally be 20 per course, depending on how many instructors will be partaking. The hope is local instructors will work in conjunction with neonatal instructors. The course to be run will be based on both the Australian Resuscitation Council guidelines for neonatal resuscitation and the NSW Health guidelines mandating training for all those involved in the care of newborn infants. The project covers Western, Greater Eastern and Northern Child Health Networks but will be coordinated by Paul Craven and Denise Kinross, Hunter New England Neonatal Outreach team members and head of the Perinatal Service Network Neonatal Resuscitation Committee. With 32 courses running and giving the opportunity for metropolitan clinicians to visit rural sites not only will education be improved but lines of communication and referral will be further enhanced.
Key performance indicators
The success of the project will be measured by:
- To ensure all hospitals in NSW providing maternity services has access to an advanced neonatal resuscitation workshop for medical/nursing and associated specialists in 2009/2010.
- To ensure levels of confidence in NSW are improved for those caring for newborn infants in the art of neonatal resuscitation from confidence levels highlighted in 2002 survey (Foster K, Craven P et al )
- To ensure blood gas interpretation and x-ray interpretation are improved in all hospitals birthing women in NSW so appropriate referrals are made to specialist NICU’s
Progress
- Manikins have been purchased
- Course has been developed
- Meetings have occurred
- Over the 2 year period the course was taught 34 times in geographically relevant areas. 6 tertiary hospitals provided the courses and opened them up in each case to all local hospitals involved. Each course was coordinated by local champions to ensure local attendance and maximal support
- A survey was performed in recent times, which was a repeat of a previous survey looking at self-reported confidence. This showed a trend towards improved confidence. Individuals have reported their own confidence to the instructors and some have telephoned to report when procedures have been performed they could not do previously
- Blood gas analysis has been taught in each area. By the time the resuscitation and cooling had been taught there was not time to teach x-ray interpretation. This has been taught in various locations previously and will continue to be provided, but it must not take the place of resuscitation training and people found the day was too long otherwise
- All workshops followed a standard format. A standard teaching program was developed with PPP to start and every presenter had written information regarding what to say to each slide. Rreading material was provided for all participants and for course instructors to distribute as required. 2 dolls were provided for each site teaching the skills required. A Neopuff and saturation monitors were borrowed to teach with in each hospital. Ccertificates of attendance were provided and feedback collected on each person who attended.
- Due to the success of this project it is continuing through the 2011-2013 funding biennium.
For more information contact:
Paul Craven
Neonatologist
NICU, John Hunter Children’s Hospital
Phone: 02 4985 5383