title: Aftermath of a clinical trial: evaluating the sustainability of a medical device intervention in Ghana.
abstract: A randomized controlled trial recently demonstrated that continuous positive airway pressure (CPAP) effectively decreases respiratory rate in children presenting to Ghanaian district hospitals with respiratory distress. A follow-up study 16 months later evaluated the extent to which the skills and equipment necessary for CPAP use have been maintained. Seven of eight CPAP machines were functional, but five of eight oxygen concentrators and three of four electric generators were non-functional. Nurses trained by US study personnel (first-generation) and nurses trained by Ghanaian nurses after the study (second-generation) were evaluated on CPAP knowledge and skills. Twenty-eight nurses participated in the study, 9 first-generation and 19 second-generation. First-generation trainees scored significantly higher than second-generation trainees on both skills and knowledge assessments (p = 0.003). Appropriate technical support and training must be ensured to address equipment maintenance. Protocolization of the training program, in conjunction with skills and knowledge assessment, may improve acquisition and retention among second- and future-generation trainees.
authors: Department of Pediatrics, Columbia University, New York, NY 10032, USA.
authors: Patrick T
authors: PT
authors: Wilson
authors: Joshua C
authors: JC
authors: Brooks
authors: Easmon
authors: E
authors: Otupiri
authors: Rachel T
authors: RT
authors: Moresky
authors: Marilyn C
authors: MC
authors: Morris
mesh_terms: D000328:Adult; D002983:Clinical Competence; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D004509:Education, Nursing, Continuing; D004521:Educational Measurement; D005260:Female; D005500:Follow-Up Studies; D005869:Ghana; D006801:Humans; D007234:Infant, Premature; D007318:Inservice Training / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017283:Neonatal Nursing / Q000193:education / Q000379:methods; D015397:Program Evaluation; D012127:Respiratory Distress Syndrome, Newborn / Q000628:therapy*; D056152:Respiratory Rate; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: developing countries; ethics; nasal continuous positive airway pressure; pediatrics; training