Pediatric


COCHRANE SYSTEMATIC REVIEW: Standardised formal resuscitation training programmes for reducing mortality and morbidity in newborn infants
Implications for practice: It is up to individuals to maintain their knowledge.
Review Overview: Review question: Does training healthcare providers in standardised formal neonatal resuscitation training (SFNRT) programmes reduce neonatal mortality and morbidity, improve acquisition and retention of knowledge and skills or change teamwork and resuscitation behaviour? Background: One in 10 newborns need some resuscitation (first aid given when breathing or a heartbeat is not detected) at birth. There are many different newborn resuscitation programmes but the effectiveness of these programmes in decreasing deaths or brain injury due to lack of oxygen has not been reviewed. Study characteristics: We searched for studies that evaluated the effectiveness of newborn resuscitation programmes in April 2014 and updated in March 2015 and found five community-based studies (187,080 deliveries) and nine mannequin-based studies (626 newborns). Results and quality of the evidence: Moderate quality evidence from three studies suggested that training in newborn resuscitation probably decreases newborn deaths in the first seven days after birth. Low quality evidence from one study suggested that newborn resuscitation training may decrease newborn deaths in the first 28 days after birth. All three studies were performed in low-income settings and their findings may have limited applicability to high-income settings. We also found that teaching teamwork in addition to resuscitation training may improve team behaviour and decrease time for resuscitation (two studies, low quality evidence) but the effect on performance on resuscitation was uncertain. It is uncertain whether resuscitation programmes increase learners' knowledge and skills immediately and knowledge at six months because the quality of evidence was very low. Similarly, whether boosters to neonatal resuscitation help in retaining knowledge or performing resuscitation appropriately remain uncertain (the quality of evidence was very low). Also, whether visual or electronic aids for helping making decisions during resuscitation, improve resuscitation performance was uncertain (one study did not show effect but one electronic decision support tool with prompts improved resuscitation performance) (low quality evidence). We strongly encourage future studies to report outcomes related to long-term health, such as brain injury due to lack of oxygen, fits and long-term brain development. Effective methods to enhance teamwork behaviour, learning and retention of resuscitation knowledge and skills are needed.
LINK to Cochrane Library: Issue 9, 2015 http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD009106.pub2/abstract