Educating neonatal nurses in Brazil: a before-and-after study with interrupted time series analysis

Area of Science:

• Neonatal care
• Medical education
• Public health

Background:

• Preterm birth is a major cause of infant mortality and morbidity, including retinopathy of prematurity (ROP).
• Optimal intensive neonatal care is crucial but often limited by inadequately trained nursing staff in developing regions.

Purpose of the Study:

• To evaluate the impact of an educational intervention on neonatal outcomes, including survival and severe ROP.
• To assess the effectiveness of a 'POINTS of Care' educational package for nurses in 5 Brazilian neonatal units.

Main Methods:

• An uncontrolled before-and-after study with interrupted time series analysis was employed.
• A participatory-developed, self-administered educational package ('POINTS of Care') focused on pain, oxygenation, infection, nutrition, and temperature management.
• Data on infant outcomes were collected over two 1-year periods before and after a 3-month intervention implementation.

Main Results:

• 74% of nursing staff received training, showing improved knowledge and practices in areas like oxygen monitoring.
• No statistically significant changes were observed in infant survival rates, severe ROP incidence, or sepsis rates post-intervention.
• Staff attrition and replacement challenges potentially impacted the intervention's effectiveness.

Conclusions:

• The educational package did not yield significant improvements in key neonatal outcomes.
• Future research should address implementation barriers, team dynamics, leadership, and governance in neonatal care settings.