P2B079: NNETS (Neonatal Nurses' Essential Training and Skills) Program - A Low-cost-hybrid Education Model for Least Developed Countries (LDC)

Background: Least Developed Countries (LDCs – 46 listed by UN) are low-income countries with low human assets, including trained health care delivery professionals. Many LDCs have no formal neonatal nursing programs and travel abroad for training is impractical. Despite great need for neonatal care no neonatal nurse training programs are available in Uganda. Therefore, we pilot-tested a 9-month low-cost hybrid training program (NNETS). Our goal was to address the challenge of time and cost of training NN (NN) by successfully training NN at their respective working site and incorporate the training around their daily work routine.

Methods:

Design: A pilot NNETS program was designed in consultation with US national neonatal teaching experts, including the Council of International Neonatal Nursing (COINN).
Curriculum: Published curriculum and competencies (COINN) for NN were used to develop and deliver a 48-lecture, 6-month didactic program (March to September 2022) using remote teaching sessions via Zoom.
Practicum: A 5-week on-site skills training and mentorship was provided by 5 expert US trained NN at Nakasero Hospital in Kampala, Uganda, from September to October 2022.
Faculty: A dedicated faculty of 18 experienced NN, NNPs, and Neonatologists from leading universities and nursing programs in the US conducted the remote didactic sessions via live Zoom. Presentations that were recorded and archived on the website for continuing reference.
Learners: NN working in neonatal units of three hospitals (Nakasero, St. Francis Nsambya, and Kampala Hospitals) participated in 45-minute live Zoom presentations twice weekly (Tues & Thurs).
Evaluation: Pre and Post-test questions were done for each session, and 75% attendance was mandatory. First, mid- and end-course MCQ tests were administered, and a 75% passing score was needed for continued participation. Passing an on-site day-long practical exam based on an OSCE format was required for completion. An ‘Authentication of Training’ document was given to the successful NNs.

Results: 48 nurses from three hospitals in Kampala started the program. After the first round of testing, 36 nurses passed the threshold 75% score and were allowed to continue. Participants showed a continuing increase in MCQ scores through the NNETS training period (Figure 1). All 36 nurses completed the program and were ‘Authenticated’ at a formal ceremony in September 2022. Post-program monitoring six months after completion (Mar ’23) showed 60% still had an adequate recall.
All lectures were given by unpaid volunteer faculty, and program costs were primarily related to travel and teaching materials (funding - non-profit Medical Education Resources Unlimited-MERU). The cost was approx. US $500 per nurse trained.

Conclusion: A hybrid training model using live-remote-lectures and on-site skills training is a cost and resource-effective means training NN in LDC regions. Successful training can be done as an adjunct to their daily routine without disrupting workflow.