Neonatal Resuscitation Training at Cheyenne River Health Center

In January 2024, Maggie Ryan Global Health Fellow Deborah O'Dowd, MSN, RN, CCRN, Julia Rubin-Smith MD, MSPH, CTropMed, and Kristen Early-Lindamood NNP launched the Neonatal Resuscitation Program (NRP) Plus training initiative at Cheyenne River Health Center (CRHC) in partnership with CRHC Nurse Educator, Keri Fischer. This novel training package focused on recognizing and caring for neonates who require resuscitation immediately after birth and improving neonatal care services for the Lakota Tribe of the Sioux Nation.

In response to the locally-prioritized need for additional training and resources for pediatric patients, leaders at the MCRGHP expanded its efforts to include a comprehensive educational approach for neonatal care. Clinical leaders, educators, and bedside clinicians at CRHC identified the Neonatal Resuscitation Program (NRP) as a priority training initiative for their emergency department, where, as a critical access hospital, obstetrical delivery services are critical. In response, BCH GHP introduced the NRP Plus program, which includes traditional NRP training and a supplementary "Plus" component that provides training on post-resuscitative multidisciplinary care for neonates during the 24-48 hours after birth should immediate transfer be delayed. Transfer delays are not uncommon during the winter months, when ice and snow storms prohibit transfer by road or air. This expanded training aims to enhance neonatal care in the region and has the potential to be scaled to other priority health centers in the Great Plains as identified by IHS leadership.

The NRP Plus program was a comprehensive two-day training course designed to enhance neonatal care skills. Day 1 covers the 8th edition Advanced NRP course with both didactic instruction and hands-on simulations, while Day 2 focuses on post-resuscitation care, including key topics like thermoregulation, respiratory care, and neonatal abstinence syndrome, using high-fidelity simulations for realistic practice. The training was delivered to two cohorts from various clinical backgrounds with all participants in the first cohort and nine out of ten in the second cohort successfully completing the full curriculum. Additionally, the team developed emergency resuscitation kits for neonates and created instructional videos on NRP technical skills to support ongoing staff education at CRHC.

To ensure ongoing support, bimonthly Zoom sessions continue to be held for staff to review cases and discuss clinical scenarios. Future plans include continuing the partnership to expand pediatric care and educational initiatives for the CRHC staff and the Lakota community, with additional rounds of NRP Plus training scheduled.

This project is part of a broader collaboration with Indian Health Services (IHS) to enhance pediatric care and support community health initiatives, including rural outpost care, school health programs, and childhood routine immunizations, as well as exploring ways to provide continuous pediatric and nursing support at CRHC.

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