Advancing Neonatal Care
Despite year on year improvements in the care of critically ill neonates, newborn care is not optimal. There are too few doctors and nurses who are appropriately trained in newborn care and specifically the care of sick or low birth weight newborns. The lack of staff and critical shortage of nurses and equipment as well as limited knowledge are major factors in why the mortality rate remains high. Health workers in the rural areas still lack the skills and experience to take prompt life-saving action and their knowledge of resuscitation is limited.
Prematurity and low birth weight account for more than 40% of neonatal deaths in the Da Nang neonatal intensive care unit (NICU), followed by infection and birth asphyxia. Babies born before 33 weeks gestation or with birth weight under 1,500 grams generally need more specialist care, especially for breathing and feeding issues. Survival rates in developed world countries for preterm babies born between 27 and 33 weeks gestation range from 80 to 95%. Currently at the Da Nang NICU almost all the babies under 1,000 grams and under 27 weeks gestational age are not viable.
There is no proper incubator and respiratory support to transport babies from other centres many are in a very poor condition on arrival with hypothermia that significantly reduces their chance of survival.
There is little or no chance of survival for newborns with conditions that require complex surgery in the early weeks of life; the majority of these surgeries are successfully performed in developed world countries with generally good outcomes.
There is only so much that can be achieved with basic interventions and Kangaroo Mother Care. In developed world countries premature and very sick babies are cared for by high numbers of well-trained staff with access to all the technology they need to not only save lives but also to reduce the chance of long-term damage to the babies’ organs.
The NICU mission statement is love and health for our newborns, there is no shortage of love and dedication and there is a huge hunger for knowledge and skills. The team knows it could do so much more. In 2011 the team identified education and training as their priority to enable them to provide better care for the families and their newborns.
In 2012 they worked with the Canterbury Christ Church University team to identify their training needs and requirements for guidelines to help support the delivery of good practice and move towards more baby focused care. From a formal nurse education assessment, Canterbury Christ Church University in collaboration with the Da Nang team developed a ‘bespoke’ neonatal nurse training programme. To read more – click here.
In March 2013 the neonatal nurse training programme commenced. The goal is to raise the standards of care and to cascade the benefits of their learning to support improved care across the region.