Developing an Education Package for a Tertiary Neonatal Unit in a Lower-Middle Income Country

Background: The Neonatal Intensive Care Unit (NICU) in University Teaching Hospital, Lusaka, is Zambia’s only tertiary neonatal unit. It is a busy unit with eighty to a hundred infants. On average, there are twelve infants admitted daily, with the average monthly mortality being 25.1%. In 2015, the Zambian neonatal mortality rate was 21 per 1,000 live births.

Currently, there is no formal neonatal nursing training. Discussions with both nursing and medical staff highlighted concerns about inadequate training. This correlated with observed suboptimal clinical practice over a two-month period.

Objective: To bridge the knowledge gaps in neonatal nursing through delivering an education package that was established by a UK paediatric nurse with support from a UK paediatric trainee.

Methods: A pilot course of three free separate masterclass sessions were delivered. Topics were based on areas suggested by the senior NICU sisters, neonatal consultants, discussions with NICU nursing staff and the clinical practice observed. Teaching interventions were free or low-cost, aiming to improve short- and long-term outcomes for neonates. These included therapeutic positioning, when to call for help, hypoglycaemia guidelines and neonatal life support. Attendees completed a quiz prior to the study session and afterwards, as well as a post course feedback form.

Results: The course has been attended by nursing and midwifery students and NICU staff. Almost universally, post study session quiz scores were higher than pre study session quiz scores, suggesting an increase in theoretical knowledge on the subject matter. All attendees stated that they would recommend this study session to their peers.

Conclusion: A study day involving practical and theoretical knowledge is welcomed locally, has improved knowledge base and has significant potential for future development. NICU staff will complete the quiz again four weeks after they attended a session. Further sessions are planned, with local staff continuing this work.