Impact of neonatal resuscitation training program (NRP) on resuscitation practices in teaching hospitals in India

Abstract

NRP developed by the American Academy of Pediatrics and American Heart Association has been introduced into many countries. In India NRP was introduced in 1990. Over 30,000 health care personnel have been trained so far. However, no data is available to measure the impact of NRP. This prospective study was designed to evaluate the impact of NRP on the providers and their management of BA. Two pediatricians from each of the 14 medical schools with no formal prior found training in NRP were selected for certification. Following training each institution received required resuscitation equipment. Each participant provided base line data, 3 months preceding training and data, 6 months following the NRP certification from their respective hospitals. (Table) Interestingly, the incidence of asphyxia increased significantly after the certification. There was also a significant increase in the use of B & MV, and intubation after the training. However, use of chest compression and medications decreased significantly. There was no change in number of deaths nor aspyxia related deaths. These data demonstrate that NRP certification lead to increased documentation of BA use of B & MV by 2.5 folds and drop in cc and medications by 66%. A major impact on the practices of resuscitation. The increase in intubation by 30% shows increased expertise. The lack of decrease in overall neonatal deaths or asphyxia related deaths following certification may be due to inadequate facilities for post asphyxial management and other factors. These studies demonstrate; 1) The impact NRP on the practice of resuscitation; 2) The importance of assuring post-asphyxial management to realize the benefits of resuscitation; 3) The need for further well designed studies to measure the impact of NRP on short and long term outcome; 4) The importance of establishing a data base in countries/institutions prior to introducing NRP.