P3.082: Development and Implementation of a Co-Designed Nationally Accredited Advanced Neonatal Nursing Curriculum in Tanzania

Background: Tanzania’s neonatal mortality rate is 20 deaths per 1,000 live births, far greater than the goal of 12 deaths per 1,000 live births established by the United Nations Sustainable Development Goals. The World Health Organization recommends decreasing variation in training and increasing capacity of neonatal nurses as a key action in addressing neonatal mortality. Our multi-disciplinary global team developed and implemented a co-designed neonatal nursing curriculum to improve nurses’ knowledge and skills in a Tanzanian hospital’s newborn unit.

Methods: Tanzanian neonatal nurses identified the need for a structured nursing curriculum. Kern’s Six Steps was used as a framework for curriculum development. A needs assessment was created to evaluate 15 clinical topics and skills. Tanzanian respondents scored topics on importance and frequency of use in clinical nursing practice on a scale of one to three (one being least important/used; three being most important/used). Results from the needs assessment were used to co-develop a hybrid virtual and in-person 10-month curriculum in a flipped classroom model with 20 pre-recorded lectures supplemented by discussion sessions. Scheduled assessments included pre-, mid-, and post-curriculum and 6-month retainment to address three levels of the Kirkpatrick Model of learning evaluation. The curriculum was accredited by the Tanzania Nursing and Midwifery Council to provide participants with continuous professional development points and a sustainable local platform for the material.

Results: 11 Tanzanian respondents completed the needs assessment and scored physical exam, respiratory system, and resuscitation as most important topics (mean 2.8, SD 0.4). The most used topics were respiratory system (mean 3, SD 0), gestational age assessment (mean 2.9, SD 0.3), and physical exam (mean 2.8, SD 0.4). 12 participants completed the pre-assessment where the gastrointestinal system had the highest percentage of questions correct and the cardiovascular system had the lowest. 11 participants completed the post-assessment where the gastrointestinal system had the highest percentage of questions correct and the hematologic system had the lowest. When comparing scores of the 6 participants who completed both pre- and post-assessments, 5 topics had higher scores and 5 topics were lower, with an average attendance of 68% of total sessions for those participants. The 6-month knowledge retainment assessment was completed by 11 participants and results are being analyzed.

Conclusion: The needs assessment demonstrated topics for curriculum development. Pre-assessment indicated knowledge gaps and post-assessment demonstrated mixed changes in knowledge following curriculum completion. Potential reasons for these results include the assessment questions may not have fully evaluated participants’ knowledge and high clinical workloads limited participant attendance at discussion sessions and assessments. Currently, the collaborative multi-disciplinary team is refining a focused curriculum that partners knowledge with a skills checklist for expansion to the remainder of nurses in the neonatal ward, other hospital services caring for newborns, and referring community sites.