Development and pilot implementation of a co-designed nationally accredited advanced neonatal nursing curriculum in Tanzania

Abstract

Introduction Tanzania has greater neonatal deaths (21 deaths per 1000 live births) compared to the goal (12 deaths per 1000 live births) described by the United Nations  Sustainable Development Goals. The World Health Organization recommended decreasing training variation and increasing capacity of neonatal nurses to address neonatal mortality. This project codesigned and implemented a neonatal nursing curriculum in a Tanzanian hospital to improve skills and knowledge. 
Methods: Kern’s Six Steps was used for curriculum development by a  multi-national, interdisciplinary team. A needs assessment evaluated clinical topics and skills. A ten-month hybrid virtual and inperson curriculum with assessments in a flipped classroom model with pre-recorded lectures and scheduled discussion sessions was developed. The curriculum was accredited by the Tanzania Nursing and Midwifery Council to provide continuous professional development points and a sustainable  local platform for the material.
Results: The needs assessment demonstrated physical examination, respiratory system, gestational age assessment, and resuscitation as most important and frequently used topics in clinical practice. Participants who completed both pre-curriculum and post-curriculum assessments demonstrated mixed results with scores. The six-month retainment assessment demonstrated overall improvement in knowledge (mean +7%) compared to the postcurriculum assessment. 
Conclusion: Currently, the team is refining the curriculum to combine education with bedside skills training in the next expansion efforts to the remainder of nurses in the Neonatal Ward, other hospital sites, and referring community sites. The impact on specific clinical outcomes, such as PIV  infiltrates and unplanned extubations, will be evaluated to speak to higher levels of the Kirkpatrick Model.