Impact of contextualized pediatric resuscitation training on pediatric healthcare providers in Botswana |
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| Affiliation: | 1. Children''s Hospital of Philadelphia, 3400 Civic Center Blvd, Philadelphia, PA 19104, United States;2. Botswana-UPenn Partnership, 214 Independence Ave, Gaborone, Botswana;3. Children''s Hospital of Philadelphia 3400 Civic Center Blvd, Philadelphia, PA 19104, United States;4. Naval Hospital, 3475N Saratoga St, Oak Harbor, WA 98277, United States;5. Clinical Services, Botswana Ministry of Health, Gaborone, Botswana;6. Princess Marina Hospital, Botswana Ministry of Health, Gaborone, Botswana;7. University of Botswana School of Medicine, Gaborone, Botswana;1. Department of Ophthalmology, KCM College, Tumaini University, Moshi, Tanzania;2. Kilimanjaro Centre for Community Ophthalmology, PO Box 2254, Moshi, Tanzania;1. Good Hope Hospital, Sutton Coldfield, UK;2. Post Graduate Medical Institute, Anglia Ruskin University, Chelmsford, UK;3. University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK;4. Warwick Medical School, University of Warwick, UK;1. School of Nursing, Midwifery & Social Work, Mary Seacole Building, University of Salford, Frederick Rd Campus, Salford M6 6PU, UK;2. Manchester Medical School, ATR4, Education Research Centre, University Hospital of South Manchester, Southmoor Road, Manchester M23 9LT, UK;3. Manchester Medical School, Stopford Building, Oxford Rd, Manchester, Greater Manchester M13 9PT, UK;4. Stepping Hill Hospital, Poplar Grove, Stockport, Cheshire SK2 7JE, UK;5. University Hospital of South Manchester NHS FT, Southmoor Road, Manchester M23 9LT, UK;1. Associate Nurse Unit Manager (ANUM), Australia;2. Professor of Nursing, Australia;3. Nurse Unit Manager (former), Australia;4. Intensive Care Specialist, Australia;5. Adjunct Senior Research Fellow and PhD student DEPM Monash University, Adjunct Associate Professor University Melbourne, Medical Director Critical Care Outreach Austin Hospital, Australia;1. Department of Pediatrics, Royal Hobart Hospital and University of Tasmania, Hobart, Tasmania, Australia;2. School of Engineering, University of Tasmania, Hobart, Tasmania, Australia;3. The Faculty of Health Sciences, Linköpings University, Linköpings, Sweden;4. Newborn Research, The Royal Women''s Hospital, Melbourne, Victoria, Australia;5. The University of Melbourne, Melbourne, Victoria, Australia;1. Department of Anesthesiology, Mount Sinai Medical Center, New York, NY, USA;2. Department of Anesthesiology, Montefiore, Bronx, NY, USA |
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| Abstract: | BackgroundWorldwide, 6.6 million children die each year, partly due to a failure to recognize and treat acutely ill children. Programs that improve provider recognition and treatment initiation may improve child survival.ObjectivesDescribe provider characteristics and hospital resources during a contextualized pediatric resuscitation training program in Botswana and determine if training impacts provider knowledge retention.Design/methodsThe American Heart Association's Pediatric Emergency Assessment Recognition and Stabilization (PEARS) course was contextualized to Botswana resources and practice guidelines in this observational study. A cohort of facility-based nurses (FBN) was assessed prior to and 1-month following training. Survey tools assessed provider characteristics, cognitive knowledge and confidence and hospital pediatric resources. Data analysis utilized Fisher's exact, Chi-square, Wilcoxon rank-sum and linear regression where appropriate.Results61 healthcare providers (89% FBNs, 11% physicians) successfully completed PEARS training. Referral facilities had more pediatric specific equipment and high-flow oxygen. Median frequency of pediatric resuscitation was higher in referral compared to district level FBN's (5 [3,10] vs. 2 [1,3] p = 0.007). While 50% of FBN's had previous resuscitation training, none was pediatric specific. Median provider confidence improved significantly after training (3.8/5 vs. 4.7/5, p < 0.001), as did knowledge of correct management of acute pneumonia and diarrhea (44% vs. 100%, p < 0.001, 6% vs. 67%, p < 0.001, respectively).ConclusionFBN's in Botswana report frequent resuscitation of ill children but low baseline training. Provider knowledge for recognition and initial treatment of respiratory distress and shock is low. Contextualized training significantly increased FBN provider confidence and knowledge retention 1-month after training. |
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| Keywords: | Developing countries Emergency training, Pediatric emergency training Resuscitation education PEARS Pediatric Emergency Assessment Recognition and Stabilization Resource-limited setting |
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