Simulation to Support Standardization of Delivery Room Management of the Very Low Birth-Weight Infant.

BACKGROUND: The birth of a very low birth-weight (VLBW) infant occurs infrequently, especially in the community hospital setting. It is critical that the team managing care of the infant in its first minutes of life follow evidence-based resuscitation guidelines and practices to optimize outcomes for this population. PURPOSE: To implement a simulation program in a community hospital setting that supports standardized evidence-based delivery room practices of the premature infant born less than 30 weeks' gestation. METHODS: Two VLBW emergent delivery scenarios were developed utilizing the neonatal resuscitation program scenario template. Special care nursery interprofessional team members from a community hospital were invited to participate in the simulation program (n = 28). Participants were asked to complete a neonatal version of the Emergency Response Confidence Tool, then view a short presentation related to delivery room management of VLBW infants. Participants attended a simulation program and completed the confidence tool after simulation. The simulation facilitator and unit educator documented team actions during each simulation session. FINDINGS/RESULTS: Fifteen opportunities for improvement within 4 simulation sessions were identified and categorized. Fourteen paired pre- and postsurveys were analyzed. Reported confidence increased in 22 of 23 resuscitation-related items. IMPLICATIONS FOR PRACTICE: Education and simulation programs providing opportunities to experience high-risk, low-frequency VLBW delivery situations can assist in identifying areas for improvement and may improve team member confidence. IMPLICATIONS FOR RESEARCH: Additional research is needed to assess whether results would be similar if this program were provided at all levels of neonatal care throughout the healthcare system.

Media Exposure, Behavioural Risk Factors and HIV Testing among Women of Reproductive Age in Papua New Guinea: A Cross-Sectional Study.

BACKGROUND: Reproductive health remains a major health concern in developing countries such as Papua New Guinea (PNG). The prevalence of human immunodeficiency virus (HIV) in PNG is the highest in the Southern Pacific region, with women having a higher risk of contracting the infection. Hence, there have been several policies aimed at mitigating the spread of the disease. One of these policies include the use of mass media as a health promotion tool to educate the population on the risk of the disease. Therefore, this study aimed at investigating the association of mass media to HIV testing among women. METHODS: Data were obtained from the PNG Demographic and Health Survey (DHS) of 2019. A total of 15,005 reproductive-age women was included in this analysis. RESULTS: The results showed that women with low (aOR = 1.63, 95% CI: 1.39, 1.90) and high (aOR = 1.53, 95% CI: 1.36, 1.72) media exposure were more likely to undertake HIV testing compared to those with no media exposure. Compared to no education, women with incomplete primary (aOR = 1.22, 95% CI: 1.06, 1.40), complete primary (aOR = 1.56, 95% CI: 1.30, 1.87), incomplete secondary (aOR = 2.18, 95% CI: 1.85, 2.58), complete secondary (aOR= 2.33, 95% CI: 1.77, 3.09) and higher (aOR = 3.38, 95% CI: 2.57, 4.46) education were more likely to undertake HIV testing. Compared to women with the poorest wealth index, women with richer indexes were more likely to undertake HIV testing. Women living in rural areas were less likely to undertake HIV testing (aOR = 0.72, 95% CI: 0.63, 0.82). However, marital status, knowledge of transmission and religion were not associated with HIV testing. CONCLUSION: In conclusion, this study provides strong evidence that mass media exposure increases the likelihood of HIV testing in women of reproductive age in PNG. Mass media campaigns would serve as a cost-effective health promotion tool against the spread of disease.