title: Improving outcomes of transported newborns in Panama: impact of a nationwide neonatal provider education program.
abstract: OBJECTIVE
  To determine whether national distribution of a neonatal provider education program (the S.T.A.B.L.E. Program) positively impacts the health of ill newborns that require transport in Panama.
  
  
  METHODS
  The investigation used a prospective, pre- and postintervention study design with a double pretest. The 10 birthing centers in Panama that routinely transport the greatest number of newborns received the education program intervention. Primary outcomes were body temperature and serum glucose level on arrival at the referral facility. Length of stay and mortality were evaluated as secondary outcomes. Variation in outcome indicators was compared for 7 months before and after the intervention. Data from all live newborns transported from outlying birthing center study sites during the study dates were included in the investigation.
  
  
  RESULTS
  A total of 136 and 146 newborns were transported during the observation and postintervention periods, respectively. Significantly more patients in the postintervention group had temperatures within the normal range (56% in postintervention group vs 34% in observation group; P<0.01). No statistical difference was observed in serum glucose levels, length of stay or mortality.
  
  
  CONCLUSIONS
  Distribution of a neonatal provider educational program was associated with improved thermal management of transported newborns in Panama. Further study will help to confirm this association and determine the extent to which these findings are generalizable to other resource-constrained settings.
authors.affiliation: Division of Neonatology, UMass Memorial Children's Medical Center, Worcester, MA 01605, USA. jmspector@aap.net
authors.forename: J M
authors.initials: JM
authors.lastname: Spector
authors.forename: H Solano
authors.initials: HS
authors.lastname: Villanueva
authors.forename: M E
authors.initials: ME
authors.lastname: Brito
authors.forename: P Gallardo
authors.initials: PG
authors.lastname: Sosa
mesh_terms: D016550:Birthing Centers; D002983:Clinical Competence; D003479:Curriculum; D004502:Education, Medical, Continuing; D006801:Humans; D007003:Hypoglycemia / Q000517:prevention & control; D007035:Hypothermia / Q000517:prevention & control; D007224:Infant Care / Q000379:methods / Q000592:standards*; D007231:Infant, Newborn; D010176:Panama; D010360:Patient Transfer; D011446:Prospective Studies; D012017:Referral and Consultation