Effectiveness of simulation and video-based training on neonatal resuscitation skills acquisition and retention among nurses at Mnazi mmoja hospital in Zanzibar.

Abstract

ABSTRACT Background: Nurses should be skilled and competent to provide quality neonatal resuscitative measures to prevent complication and deaths related to births asphyxia (BA). Incorrect, ineffective or unsafe forms of practice are widespread in new-born care. Neonatal resuscitation (NR), routine trainings play key role on reinforcing appropriate neonatal resuscitation (NR) skills practices and consequently lead to reduction of neonatal morbidity and mortality. Simulation and video assisted training have been widely introduced particularly in new-born delivery units worldwide as an effort to reinforce skills acquisition and retention. Neonatal resuscitation skills decay over time post training but the optimal period and impact of simulation and video-based training among nurses attending newborn delivery low-resource settings is not well established. Similarly, there is no previous study conducted on the use of video assisted and simulation training as the modalities to train nurses on NR skills that has been conducted in Zanzibar. Aim of the study: We aimed to determine the effectiveness of simulation and video-based training on neonatal resuscitation skills acquisition and retention among nurses at Mnazi Mmoja Hospital (MMH) in Zanzibar. Methodology: Randomized control trial was used to assess the effectiveness of simulation and video-based training on skills acquisition and retention. A consecutive sampling technique was used to enroll 56 nurses to participate in the study, the participants were randomized into two groups followed by assessment of their baseline neonatal resuscitation skills. One group as the control arm was given simulation training modality and the other group as the intervention arm was exposed to both simulation and video assisted training modality. Both groups received immediate posttest and later on two months posttest assessment on neonatal resuscitation skills. The analysis was conducted using SPSS v. 26. Frequency distribution tables and statistical diagram was used to summarize categorical variables. Continuous variables were described using means and standard deviations, t-test was used to compare mean scores between two groups and between the assessments period. xii The association between categorical variables were described using chi-square tests. The repeated measures ANOVA was used to test for the effectiveness of the simulation and video based training over two months period. Significant difference was established based on 5% level of significance and 95% confidence interval. Result: A total of 56 nurses were included in this study. The study shows that only 39% (22/56) nurses demonstrated adequate baseline neonatal resuscitation skills according to standard guidelines. Simulation and video-based training was effective on neonatal resuscitation skills acquisition and retention over two months compared to baseline(p<0.001). There is no significant difference in NR skills acquisition on immediate post-test between the intervention and control group(p=0.448). Both groups experienced a marked skills deterioration over two months period post training where the mean score declined from 94.07% to 82.76% (p<0.001) and mean score of 92.90 to 77.89% (p<0.001) for intervention and control group respectively. Despite the decline in skills observed in both groups, there was a significant difference in mean skills gain over two months compared the skills prior training (p<0.001). The intervention arm showed superior positive effect over the control arm in the two months skills performance with significant difference (p=0.038) Conclusion and recommendation: This randomized control trial demonstrated that simulation and video based training modality has shown to be effective on training neonatal resuscitation skills, adding video to the simulation-based training have positive effect on reinforcing neonatal resuscitation skills retention post training. The study also demonstrated that there is significant decline in neonatal resuscitation skills that occurred as early as two months post training, so frequent booster sessions are of paramount important in maintaining good performance of neonatal resuscitation skills. A mixed method study on a bigger population and longer duration should be embarked upon to assess the effectiveness of adding video to standard neonatal resuscitation simulation training on the competence of frontliners working at delivery suits.