Designing, developing and applying an instructional framework for a neonatal resuscitation program: Action research

This research was conducted to design, develop, and implement an in-house training framework aimed at improving the skills of healthcare professionals in newborn resuscitation practices. Action research has an inherently researcher-participant collaborative nature. An action research design was employed in this study, which was carried out with healthcare workers at a state hospital providing maternity services from February 1, 2020, to January 31, 2022. Both qualitative (observations, individual interviews and a focus group interview) and quantitative (knowledge assessment tests) data collection techniques were utilized in the study. Data were collected from researcher notes, the Neonatal Resuscitation Program (NRP) Knowledge Assessment Test, the Post-Training NRP Knowledge Assessment Test, observations, individual interviews, and focus group discussions. Quantitative data were analyzed using descriptive statistics, the Mann-Whitney U, Kruskal-Wallis and Wilcoxon tests; content analysis was employed for qualitative data. When the NRP Knowledge Assessment Test and the Post-training NRP Knowledge Assessment Test median scores were compared, it was found that the median NRP knowledge assessment test score was 43.0 (29.0-52.0), and the median post-training NRP knowledge assessment test score was 88.0 (85.0-93.0). A statistically significant difference was observed in the comparison of the participants' median scores in the NRP knowledge assessment test and the post-training NRP knowledge assessment test (p < 0.001). According to the data from the individual interviews, it was found that the participants felt challenged by neonatal resuscitation, they did not use many aspects of their knowledge, there were communication problems between teams, and they expressed a need for training. It was observed that the participants could not perform the required routine practices fully and accurately and additionally could not perform neonatal resuscitation practices, including neonatal assessments, in line with the algorithms. During this action research, the deficiencies in medical equipment for neonatal resuscitation practices identified in the institution where the study was conducted were eliminated and the equipment was made operational and usable. Improvements were also made in the use of risk assessment and recording forms, the provision of flow charts and informative documents in the practice areas, and the organization of the working system of midwives. During this process, theoretical and practical training was provided to improve the knowledge and skills of health personnel in neonatal resuscitation practices. In addition, four mentors were trained and assigned to ensure the sustainability of all the improvements made. This research has revealed institutional infrastructure problems, along with knowledge and application deficiencies regarding neonatal resuscitation practices among healthcare professionals.