Mobile Virtual Simulation Training in Essential Newborn Care for Healthcare Workers in Low and Middle Income Countries

为低收入和中等收入国家的医护人员提供基本新生儿护理的移动虚拟模拟培训

基本信息

批准号：
10268053
负责人：
Rachel A Umoren
金额：
$ 19.31万
依托单位：
UNIVERSITY OF WASHINGTON
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-17 至 2023-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10268053
关键词：
Address Age Asphyxia Back Birth Breathing COVID-19 COVID-19 pandemic Car Phone Caring Cellular Phone Cessation of life Child Health Child Mortality Collaborations Communities Community Health Competence Country Dose Educational Curriculum Equipment Exclusive Breastfeeding Eye Failure Feedback Frequencies Goals Handwashing Health Personnel Health Technology Health care facility Healthcare Immunization Infant Infant Care Infant Health Information Technology Infrastructure International Intervention Knowledge Learning Live Birth Maintenance Manikins Maternal Health Measures Methods Morbidity - disease rate Mothers Neonatal Neonatal Mortality Newborn Infant Nigeria Outcome Penetration Performance Periodicity Persons Postnatal Care Quality of Care Randomized Controlled Trials Recommendation Research Social Distance Standardization Supervision Testing Time Training Training Support Umbilical cord structure Update Vitamin K Work base clinical practice evidence base experience improved innovation intrapartum low and middle-income countries migration mobile computing mortality neonatal care neonatal death neonatal health neonatal resuscitation premature prototype resuscitative care rural area simulation skills skills training tool urban area usability virtual virtual reality virtual reality simulation

项目摘要

PROJECT SUMMARY/ABSTRACT In 2019, there were 2.4 million newborn deaths, most of which are preventable. At 36 per 1000 live births, Nigeria has one of the highest neonatal mortality rates in the world. The top two causes of neonatal mortality are intrapartum asphyxia or failure to breathe at birth and prematurity. Neonatal resuscitation training reduces asphyxia-related newborn mortality and morbidity and simple interventions such as warmth, warmth, hand washing, early and exclusive breastfeeding, umbilical cord care, eye care, vitamin K administration, and immunization decrease neonatal mortality. However, initial gains in health care worker knowledge and skills rapidly decay, sometimes in a matter of weeks after training. In-person refresher training and low-dose, high frequency (LDHF) practice using manikins are proven educational approaches, but require facility space, equipment and supervision, that are often unavailable in LMICs due to lack of infrastructure, staff shortages and high rates of staff turnover. On the other hand, the high penetration of mobile smartphones and cellular network connectivity in LMICs make innovative mobile virtual simulation training feasible in LMICs. Virtual simulations can be engaged at the learner’s convenience, on their own smartphone, with game-based automated feedback that is ideal for episodic learning. Virtual simulation refresher training provides an opportunity to support the retention of essential newborn care knowledge and skills over time and to encourage migration of these skills into actual clinical practice. We propose to use mobile virtual simulations to provide accessible, standardized refresher training. Our hypotheses are that virtual simulations will provide acceptable, effective refresher training; support the retention of newborn resuscitation and care knowledge and skills among healthcare workers in LMICs; and reduce neonatal mortality. To test these hypotheses we will: 1) Develop and evaluate the usability, feasibility, acceptability and educational efficacy of Virtual Essential Newborn Care (vENC) mobile virtual simulations on essential newborn care in healthcare workers who care for newborns in community and facility-based settings; 2) Conduct a stepped wedge cluster randomized controlled trial of vENC for refresher training vs. standard practice. This will evaluate the impact of vENC refresher training on 7-day neonatal mortality rates at participating healthcare facilities. We will also measure the impact of vENC training on neonatal care knowledge and skills in healthcare workers who provide newborn care in community and facility-based settings. In addition, we will work with our partner, Microsoft to strengthen local capacity for advanced mobile technologies and research in Nigeria. If proven effective, the vENC mobile simulations could provide an accessible tool to reduce newborn mortality and morbidity and support the delivery of essential newborn care in LMICs.

项目概要/摘要 2019 年，尼日利亚有 240 万人死亡，其中每 1000 名活产婴儿中有 36 人死亡，其中大部分是可以预防的。新生儿死亡率最高的两个国家之一。产时窒息或出生时呼吸困难以及早产儿的复苏训练会减少。窒息相关的新生儿死亡率和发病率以及简单的干预措施，例如保暖、保暖、手部护理清洗、早期纯母乳喂养、脐带护理、眼睛护理、维生素 K 给药以及免疫接种降低了新生儿死亡率，但卫生保健工作者的知识和技能取得了初步进展。快速衰减，有时在培训后几周内和低剂量、高剂量下。使用人体模型进行频率（LDHF）练习是行之有效的教育方法，但需要设施空间，由于缺乏基础设施、人员短缺和中低收入国家往往缺乏设备和监督员工流动率高。另一方面，中低收入国家中移动智能手机和蜂窝网络连接的高普及率使得在中低收入国家可行的创新移动虚拟仿真培训学习者可以参与虚拟仿真。方便，在自己的智能手机上，具有基于游戏的自动反馈，非常适合情景学习。虚拟模拟复习培训提供了支持保留基本新生儿护理的机会随着时间的推移，我们建议将知识和技能转移到实际的临床实践中。使用移动虚拟模拟提供可访问的标准化复习培训。我们的假设是，虚拟模拟将提供可接受的、有效的复习培训；中低收入国家医护人员保留新生儿复苏和护理知识和技能；为了测试这些假设，我们将： 1) 开发并评估可用性、可行性、虚拟基本新生儿护理 (vENC) 移动虚拟模拟的可接受性和教育效果在社区和设施环境中照顾新生儿的医护人员的基本新生儿护理； 2) 进行 vENC 的阶梯式楔形聚类随机对照试验，用于复习训练与标准训练这将评估 vENC 复习训练对参与的 7 天新生儿死亡率的影响。我们还将衡量 vENC 培训对新生儿护理知识和技能的影响。此外，我们还将在社区和设施环境中提供新生儿护理的医护人员。与我们的合作伙伴 Microsoft 合作，加强尼日利亚先进移动技术和研究的本地能力。如果被证明有效，vENC 移动模拟可以提供一种降低新生儿死亡率的可用工具和发病率，并支持在中低收入国家提供基本的新生儿护理。