Necrotising enterocolitis (NEC) is a life-threatening gastrointestinal condition predominantly affecting preterm infants. The majority of patients with NEC are treated medically, however, approximately 25
BACKGROUND:Research on spontaneous preterm birth (sPTB) is deeply important to the patients it serves. There is an absence of the patient's voice on the experience of research participation. MATERIALS/METHODS:This prospective mixed-method study examined the experience of participants of a preterm birth research study. Recruited patients had significant risk factors for spontaneous preterm birth and were offered enrolment in a preterm birth study. Participants enrolled in early pregnancy and continued participation until 6 weeks postpartum. At the postnatal visit, they completed a survey on their experience of participation. Responses were analysed using reflexive thematic analysis. RESULTS:In total, 112 women completed the study participation survey. Motivations for recruitment included the altruistic goal of protecting other women and families from spontaneous preterm birth (54.5%, 61/112) and interest in the scientific rationale of the study rooted in the microbiome (10.7%, 12/112). 91.0% enjoyed participating in the study. Participant satisfaction with enrolment related to perception of improved clinical care (26.8%, 30/112), continuity of care with the research team (20.5%, 23/112), perceived improved clinical outcome they attributed to study participation (9.8%, 11/112) and symptom benefit from the intervention (1/8%, 2/112). CONCLUSIONS:Women at risk of spontaneous preterm birth were motivated for study participation by the goal of protecting other women and families from preterm birth. Participant satisfaction related to perceived improved clinical care and continuity of care. Participants had a strong appetite for results dissemination. These findings highlight the willingness of patients to participate in research, even in the setting of a pregnancy at risk of preterm birth.
Proficiency-based training (PBT) is a novel approach for accelerating skills acquisition in a simulated environment. Successful implementation of PBT programmes promises to improve patient care and safety by allowing healthcare professionals to acquire proficiency in clinical skills without learning for the first time in clinical practice. To-date, the evidence around proficiency-based training in healthcare settings has concentrated on the acquisition of surgical skills. This scoping review aims to clearly determine the existing evidence relating to the use of PBT in the education of healthcare professionals. It will also identify existing evidence about PBT in the context of non-technical skills training. A sensitive search strategy will be employed across databases including PubMED, CINAHL, SCOPUS, the Cochrane Library, EMBASE and PsychINFO to look for material addressing the use of proficiency-based methodologies in the training of healthcare professionals. Trials registries will be searched for trials which are in progress but not yet reported. All evidence pertaining to proficiency-based simulation for healthcare professionals will be considered for inclusion. The search will be limited to information published in the English language. The titles and abstracts of identified works will be screened by at least two reviewers. Relevant works which are identified through screening will be retrieved in full text and reviewed for methodological consistency with PBT. Results will be presented in tabular form and as an evidence map and will be reported in accordance with PRISMA-ScR guidelines.
Introduction Facemask leak is common with a one-handed hold and can reduce the efficacy of neonatal resuscitation. Our objective was to assess a standardised, respiratory function monitor (RFM)-guided, training intervention for two-handed neonatal positive pressure ventilation (PPV). Methods Development of a two-handed PPV training algorithm occurred through an iterative process with learner and expert feedback. Participants performed PPV via a facemask on a term manikin with feedback from the RFM display (Monivent Neo100). We first piloted the training intervention on ten clinicians over six sessions. The intervention was then assessed through a before-and-after, non-randomised simulation-based study, blinded to the RFM, comparing mask leak, tidal volume and participant feedback. Mask hold style and hand preference were recorded. Results Prior to the intervention, 17/40 (42%) had previously used two-handed PPV in clinical practice. Forty clinicians were included in the training study. Mask leak was significantly lower with a two-handed hold before training: one-handed median 27%, (IQR 3-73%) vs two-handed: 2.5% (1-31%), p<0.01 median difference (95% CI) of -5.5 (-23 to -1). Post-training mask leak was comparable between holds: one-handed median 6% (IQR 2-55%); and two-handed 2% (0-5%), p<0.01 median difference (95% CI) -4 (-18 to -1). Pre-training, 11/40 (27%) preferred two-handed compared with one-handed PPV. Following training 20/40 (50%) preferred two-handed. Conclusion Effective facemask ventilation in a neonatal manikin was associated with a two-handed hold without training or prior clinical experience. After training facemask leak was low with both holds. Feedback indicated increased participant preference for two-handed PPV after training.
