TY - JOUR

T1 - Video recording as an objective assessment tool of health worker performance in neonatal resuscitation at a district hospital in Pemba, Tanzania

T2 - a feasibility study

AU - Holm-Hansen, Charlotte Carina

AU - Poulsen, Anja

AU - Skytte, Tine Bruhn

AU - Stensgaard, Christina Nadia

AU - Bech, Christine Manich

AU - Lopes, Mads Nathaniel

AU - Kristiansen, Mads

AU - Kjærgaard, Jesper

AU - Mzee, Said

AU - Ali, Said

AU - Ame, Shaali

AU - Sorensen, Jette Led

AU - Greisen, Gorm

AU - Lund, Stine

N1 - © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2022

Y1 - 2022

N2 - OBJECTIVES: To assess the feasibility of using video recordings of neonatal resuscitation (NR) to evaluate the quality of care in a low-resource district hospital.DESIGN: Prospective observational feasibility study.SETTING: Chake-Chake Hospital, a district hospital in Pemba, Tanzania, in April and May 2019.PARTICIPANTS: All delivering women and their newborns were eligible for participation.MAIN OUTCOME MEASURES: Motion-triggered cameras were mounted on resuscitation tables and provided recordings that were analysed for quality of care indicators based on the national NR algorithm. Assessment of feasibility was conducted using Bowen's 8-point framework for feasibility studies.RESULTS: 91% (126 of 139) of women and 96% (24 of 26) of health workers were comfortable or very comfortable with the video recordings. Of 139 newborns, 8 underwent resuscitation with bag and mask ventilation. In resuscitations, heat loss prevention measures were not performed in half of the cases (four of eight), clearing the airway was not performed correctly in five of eight cases, and all newborns were suctioned vigorously and repeatedly, even when not indicated. In a quarter (two of eight) of cases, the newborn's head was not positioned correctly. Additionally, two of the eight newborns needing ventilation were not ventilated within the first minute of life. In none of the eight cases did ventilation appear to be performed effectively.CONCLUSIONS: It proved feasible to use video recordings to assess quality of care during NR in a low-resource setting, and the method was considered acceptable for the delivering women and health workers. Recordings of eight resuscitations all demonstrated deviations from NR guidelines.

AB - OBJECTIVES: To assess the feasibility of using video recordings of neonatal resuscitation (NR) to evaluate the quality of care in a low-resource district hospital.DESIGN: Prospective observational feasibility study.SETTING: Chake-Chake Hospital, a district hospital in Pemba, Tanzania, in April and May 2019.PARTICIPANTS: All delivering women and their newborns were eligible for participation.MAIN OUTCOME MEASURES: Motion-triggered cameras were mounted on resuscitation tables and provided recordings that were analysed for quality of care indicators based on the national NR algorithm. Assessment of feasibility was conducted using Bowen's 8-point framework for feasibility studies.RESULTS: 91% (126 of 139) of women and 96% (24 of 26) of health workers were comfortable or very comfortable with the video recordings. Of 139 newborns, 8 underwent resuscitation with bag and mask ventilation. In resuscitations, heat loss prevention measures were not performed in half of the cases (four of eight), clearing the airway was not performed correctly in five of eight cases, and all newborns were suctioned vigorously and repeatedly, even when not indicated. In a quarter (two of eight) of cases, the newborn's head was not positioned correctly. Additionally, two of the eight newborns needing ventilation were not ventilated within the first minute of life. In none of the eight cases did ventilation appear to be performed effectively.CONCLUSIONS: It proved feasible to use video recordings to assess quality of care during NR in a low-resource setting, and the method was considered acceptable for the delivering women and health workers. Recordings of eight resuscitations all demonstrated deviations from NR guidelines.

KW - Feasibility Studies

KW - Female

KW - Hospitals, District

KW - Humans

KW - Infant, Newborn

KW - Resuscitation/methods

KW - Tanzania

KW - Video Recording

U2 - 10.1136/bmjopen-2021-060642

DO - 10.1136/bmjopen-2021-060642

M3 - Journal article

C2 - 35584880

VL - 12

SP - e060642

JO - BMJ Open

JF - BMJ Open

SN - 2044-6055

IS - 5

ER -