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

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...

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Main Authors: Gorm Greisen, Jette Led Sørensen, Jesper Kjærgaard, Anja Poulsen, Said Ali, Tine Bruhn Skytte, Charlotte Carina Holm-Hansen, Christina Nadia Stensgaard, Christine Manich Bech, Mads Nathaniel Lopes, Mads Kristiansen, Said Mzee, Shaali Ame, Stine Lund
Format: Article
Language:English
Published: BMJ Publishing Group 2022-05-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/12/5/e060642.full
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author Gorm Greisen
Jette Led Sørensen
Jesper Kjærgaard
Anja Poulsen
Said Ali
Tine Bruhn Skytte
Charlotte Carina Holm-Hansen
Christina Nadia Stensgaard
Christine Manich Bech
Mads Nathaniel Lopes
Mads Kristiansen
Said Mzee
Shaali Ame
Stine Lund
author_facet Gorm Greisen
Jette Led Sørensen
Jesper Kjærgaard
Anja Poulsen
Said Ali
Tine Bruhn Skytte
Charlotte Carina Holm-Hansen
Christina Nadia Stensgaard
Christine Manich Bech
Mads Nathaniel Lopes
Mads Kristiansen
Said Mzee
Shaali Ame
Stine Lund
author_sort Gorm Greisen
collection DOAJ
description 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.
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spelling doaj-art-cfd2c5db4b3b447da6d6c99fe4655fb22025-08-20T01:47:55ZengBMJ Publishing GroupBMJ Open2044-60552022-05-0112510.1136/bmjopen-2021-060642Video recording as an objective assessment tool of health worker performance in neonatal resuscitation at a district hospital in Pemba, Tanzania: a feasibility studyGorm Greisen0Jette Led Sørensen1Jesper Kjærgaard2Anja Poulsen3Said Ali4Tine Bruhn Skytte5Charlotte Carina Holm-Hansen6Christina Nadia Stensgaard7Christine Manich Bech8Mads Nathaniel Lopes9Mads Kristiansen10Said Mzee11Shaali Ame12Stine Lund138 Neonatal and Pediatric Intensive Care, Rigshospitalet, Copenhagen University Hospital, Copenhagen, DenmarkJuliane Marie Centre for Children, Women and Reproduction Section 4074, Rigshospitalet, University of Copenhagen, Copenhagen, DenmarkDepartment of Clinical Medicine, University of Copenhagen, Copenhagen, DenmarkDepartment of Paediatrics and Adolescent Medicine, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark2 Public Health Laboratory–Ivo de Carneri, Chake-Chake, Tanzania, United Republic of1 Global Health Unit, Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark1 Global Health Unit, Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark1 Global Health Unit, Department of Paediatrics and Adolescent Medicine, The Juliane Marie Centre, Copenhagen University Hospital, Copenhagen, Denmark1 Global Health Unit, Department of Paediatrics and Adolescent Medicine, The Juliane Marie Centre, Copenhagen University Hospital, Copenhagen, Denmark1 Global Health Unit, Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark1 Global Health Unit, Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark2 Public Health Laboratory–Ivo de Carneri, Chake-Chake, Tanzania, United Republic of2 Public Health Laboratory–Ivo de Carneri, Chake-Chake, Tanzania, United Republic of2 Department of Neonatology, Copenhagen University Hospital, Copenhagen, DenmarkObjectives 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.https://bmjopen.bmj.com/content/12/5/e060642.full
spellingShingle Gorm Greisen
Jette Led Sørensen
Jesper Kjærgaard
Anja Poulsen
Said Ali
Tine Bruhn Skytte
Charlotte Carina Holm-Hansen
Christina Nadia Stensgaard
Christine Manich Bech
Mads Nathaniel Lopes
Mads Kristiansen
Said Mzee
Shaali Ame
Stine Lund
Video recording as an objective assessment tool of health worker performance in neonatal resuscitation at a district hospital in Pemba, Tanzania: a feasibility study
BMJ Open
title Video recording as an objective assessment tool of health worker performance in neonatal resuscitation at a district hospital in Pemba, Tanzania: a feasibility study
title_full Video recording as an objective assessment tool of health worker performance in neonatal resuscitation at a district hospital in Pemba, Tanzania: a feasibility study
title_fullStr Video recording as an objective assessment tool of health worker performance in neonatal resuscitation at a district hospital in Pemba, Tanzania: a feasibility study
title_full_unstemmed Video recording as an objective assessment tool of health worker performance in neonatal resuscitation at a district hospital in Pemba, Tanzania: a feasibility study
title_short Video recording as an objective assessment tool of health worker performance in neonatal resuscitation at a district hospital in Pemba, Tanzania: a feasibility study
title_sort video recording as an objective assessment tool of health worker performance in neonatal resuscitation at a district hospital in pemba tanzania a feasibility study
url https://bmjopen.bmj.com/content/12/5/e060642.full
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