Neonatal Nursing Education and Quality Improvement Initiatives in Liberia

Since 2021, we expanded our partnership at JFK Medical Center (JFK) in Monrovia, Liberia, as hospital leadership identified targeted neonatal nursing education as a priority initiative. JFK serves as a referral center for complex medical care throughout Liberia and is well positioned to support the specialized needs of critically ill infants. In July 2023, introduction of a commercial Continuous Positive Airway Pressure (CPAP) machine into the Neonatal Intensive Care Unit (NICU) and Under 5 Emergency Room (U5 ER) provided a resource to help improve outcomes in neonates in this resource-constrained setting.  At that time, nurse Deborah O'Dowd facilitated hands-on training to physicians and nurses on recognition and management of respiratory distress, including how to set up and manage these new machines. Additionally, Deborah provided remote continuing education through case studies and discussions, quizzes, and asynchronous technical support to both NICU and U5 ER nurses.

Returning in January 2024 training, Deb facilitated CPAP training to 28 nurses and pediatric medical residents so that they could better support its use.   Additionally, the current documentation tool was adapted to be more useful and less cumbersome to bedside staff, with job aids and and education support.  A tool was established to complete weekly Pumani checks to ensure that all necessary supplies are readily available when needed.  JFK NICU nursing leadership and bedside nursing staff have requested that monthly remote training modules continue, with enrichment and ongoing collaboration through monthly case studies and discussions.

Additionally, a NICU Quality Improvement (QI) group was developed as the Liberian NICU nurses prioritized Kangaroo Mother Care (KMC) program as their next topic of interest.  An educational program was developed to cover the topics of “prematurity” and “KMC” and offered as a half-day training including case studies, simulations, and didactic material in August 2024.