Strengthening Neonatal & Pediatric Emergency & Critical Care Nursing in Haiti

In Haiti, nurses attend college for four years, obtaining a generalized education in pathophysiology, nursing skills and theory. However, to meet the needs of high acuity children that arrive to the hospital, nurses must acquire specialized knowledge and skills to meet the complex needs of these sick children. Given that Haiti has the highest rate of infant and under-5 mortality in the western hemisphere, addressing the country’s dire health care needs by training Haitian nurses to care for critically ill children is critical to reversing these trends.  

To address this, the Haitian Ministry of Health and Hôpital Universitaire de Mirebalais (HUM) in Haiti expressed a need for enhanced nurse training for critical care specialties that would allow nurses to acquire the specialized knowledge and skills to meet the complex needs of high acuity patients. As a result, a collaborative effort began in July 2015, spearheaded by Michelle LaBrecque RN, MSN , Anna Gluckman RN, Meri Clare RN, Global Nursing Fellow Alexis Schmid DNP, MSN, MPH, RN and local partners, including the Haitian Ministry of Health, Haitian nurse leaders, and Partners in Health. This initiative aimed to develop and implement a national curriculum for neonatal and pediatric critical care nursing and establish practice standards.

The training program was structured into two six-month courses: one focused on neonatal critical care and the other on pediatric critical care. Designed using Benner’s Novice to Expert framework, the courses included weekly didactic sessions and clinical mentoring. Nurses from hospitals across Haiti were selected based on their clinical experience and leadership potential. The program involved eight-hour didactic sessions and 6-8 hour mentoring sessions each week. Each cohort was assessed through written exams, practical skills evaluations, and attitude surveys, demonstrating significant improvements in knowledge and skills.

A total of 46 nurses from 11 hospitals participated in the initial training, all of whom successfully completed the course. Follow-up evaluations and ongoing continuing education have been implemented to monitor knowledge retention and impact on patient care. Graduates of the initial courses have returned to lead subsequent cohorts, thus developing leadership skills and creating a mentorship network.

Following the first training, the program continued to expand, with graduates training new nurses annually, building a robust national network of critical care professionals in Haiti and striving to reduce the country’s high infant and under-five mortality rates.