Table 5 Provider skills: percent of providers who complete specific tasks during simulation of newborn resuscitation on an anatomical model, by provider type
Tasks* | Doctors (n = 82) | Midwives (n = 139) | p-value |
|---|---|---|---|
Getting ready | |||
Make sure equipment is ready for use | 91.7 | 91.3 | 0.937 |
Wash hands and wear gloves | 69.0 | 79.5 | 0.098 |
Quickly dry and wrap or cover the newborn | 91.7 | 92.1 | 0.909 |
Place newborn on back on clean, warm surface | 86.1 | 87.4 | 0.795 |
Tell woman what is going to be done, listen to her, and respond to her questions and concerns | 47.1 | 52.4 | 0.482 |
Provide emotional support and reassurance | 41.7 | 46.0 | 0.552 |
Mean (SD) (6 items) | 71.3 (27.1) | 74.6 (24.6) | 0.379 |
Resuscitation using bag and mask | |||
Position head in slightly extended position | 91.7 | 88.3 | 0.453 |
Suction first the mouth and then the nose | 90.3 | 89.1 | 0.788 |
Introduce catheter into mouth and suction | 69.4 | 59.7 | 0.172 |
Introduce catheter into each nostril and suction | 65.3 | 61.6 | 0.607 |
Suction well if blood or meconium is in the newborn’s mouth and/or nose | 70.6 | 67.8 | 0.688 |
If baby is still not breathing, start ventilating | 65.7 | 79.3 | 0.403 |
Recheck position of newborn’s head | 68.1 | 72.4 | 0.513 |
Place correct-sized mask on newborn’s face | 87.5 | 85.7 | 0.725 |
Form a seal between mask and newborn’s face | 84.3 | 81.6 | 0.635 |
Squeeze bag | 73.2 | 79.5 | 0.311 |
Check seal by ventilating and observing chest rise | 83.1 | 77.8 | 0.373 |
If the newborn’s chest IS rising: | |||
Ventilate at 40 breaths/minute | 87.5 | 81.0 | 0.234 |
Observe chest for easy rise and fall | 83.3 | 75.4 | 0.193 |
If the newborn’s chest IS NOT rising: | |||
Check position of the head again | 63.9 | 65.1 | 0.866 |
Reposition mask to improve seal | 61.1 | 68.8 | 0.273 |
Squeeze the bag harder; repeat suction | 56.9 | 58.4 | 0.842 |
Ventilate for 1 minute and then assess if the newborn is breathing spontaneously | 71.8 | 75.8 | 0.541 |
If breathing is normal (no indrawing or grunting): | |||
Place in skin-to-skin contact with mother | 87.5 | 81.0 | 0.079 |
Observe breathing at frequent intervals | 83.3 | 75.4 | 0.868 |
Encourage mother to begin breastfeeding | 63.9 | 65.1 | 0.174 |
If newborn is breathing with severe indrawing: | |||
Ventilate with oxygen, if available | 61.1 | 68.8 | 0.893 |
Arrange immediate transfer for special care | 56.9 | 58.4 | 0.492 |
If there is no gasping or breathing at all after 20 minutes of ventilation, stop ventilating | 71.8 | 75.8 | 0.868 |
Mean (SD) (23 items) | 71.0 (24.9) | 74.6 (24.0) | 0.950 |
Post-procedure tasks | |||
Place disposable suction catheters and mucus extractors in leak-proof container | 60.0 | 74.0 | 0.042 |
For reusable catheters and mucus extractors: | |||
Place in chlorine solution for 10 minutes | 65.7 | 76.8 | 0.095 |
Wash in water and detergent | 66.2 | 70.6 | 0.518 |
Use a syringe to flush catheters/tubing | 52.9 | 56.0 | 0.672 |
Boil or disinfect in chemical solution | 40.8 | 53.6 | 0.086 |
Take apart valve/mask and inspect for cracks/tears | 32.4 | 42.1 | 0.181 |
Wash valve/mask and check for damage | 57.1 | 69.6 | 0.080 |
Select sterilization or high-level disinfection method | 56.5 | 56.8 | 0.970 |
Wash hands and dry with clean cloth or air dry | 77.5 | 85.2 | 0.172 |
After chemical disinfection, rinse all parts with clean water and allow to air dry | 67.1 | 70.8 | 0.587 |
Mean (SD) (10 items) | 57.5 (30.7) | 65.7 (29.3) | 0.062 |
All tasks (39 items) | 66.3 (22.4) | 70.5 (20.9) | 0.185 |