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All posts by The S.T.A.B.L.E. Program

Guatemala

S.T.A.B.L.E. Program – Guatemala
By Jill Bauer, Lead Instructor
Minneapolis, Minnesota

S.T.A.B.L.E. Class Date(s): March 1-2, 2010
Barcelo Hotel in Guatemala City, Guatemala.
Hosted by Roosevelt Hospital and Abbott Laboratories in Guatemala.

  Google Map of Guatemala

 

TEACHING TEAM
Jill Bauer, BSN, RN, Neonatal Outreach Nurse, S.T.A.B.L.E. Lead Instructor
Stephanie Damlo, BSN, RN
April Weston, RN

Children’s Hospitals and Clinics of Minnesota
Minneapolis, MN

April and Stephanie demonstrate how to respond to apnea and bradycardia spells with hands on skill practice.
April and Stephanie demonstrate how to respond to apnea and bradycardia spells with hands-on skill practice.

ABOUT THIS MISSION TRIP
In March 2010, several nurses from Children’s Hospitals and Clinics of Minnesota in St. Paul and Minneapolis campuses traveled to Guatemala on behalf of the Baby’s Breathe Project, located in Minneapolis, Minnesota; and the Children’s Hospitals and Clinics of Minnesota. Baby’s Breathe Project is the non-profit start up of two NICU nurses, Meg Dornfeld and Terri Tjaden, from Children’s Hospitals and Clinics of Minnesota. While vacationing in Guatemala several years ago, they decided to reach out to a hospital to see if they could do anything to progress the education and care of neonates while they were in the country. They contacted a Neonatologist from Roosevelt Hospital in Guatemala City and that relationship began the efforts to improve the education of nurses and outcomes of infants in that region, which is now three years in the making. Our S.T.A.B.L.E. Instructor teaching team has taught the S.T.A.B.L.E. Program for the past two years in Guatemala, which has been extremely well-received and popular!

Guatemala City sits in the central region of Guatemala. The climate is very tropical, warm and humid. Our teaching began at Roosevelt Hospital, the tertiary NICU of that area which cares for approximately 85 NICU patients per day. The lowest gestational age that they care for is 28 weeks. Equipment in the unit includes ventilators, oscillators, isolettes, CPAP machines, IV pumps, UV/UA lines, etc. However, shortages of equipment, in relation to the numbers of babies, often limits which infants can be monitored and supported with the equipment. Usually 1 or 2 neonatologists staff the unit along with several nurses. Medical students also provide a very vital role in caring for patients in the NICU. In addition to these caregivers, there are also designated lactation consultants which provide important education and assistance to mothers. Kangaroo care is highly encouraged as well, with both mothers and staff participating.

A tiny infant in the NICU at Roosevelt Hospital.
A tiny infant in the NICU at Roosevelt Hospital.
One of the rooms in the NICU at Roosevelt Hospital.
One of the rooms in the NICU at Roosevelt Hospital.

The nurses love and appreciate the education very much, as options for advancing knowledge are limited. They also enjoy doing simulations which allow them to participate in actual hands-on activities, incorporating the principles taught in the classroom. After one class was completed, a physician told us that some of the nurses were enthusiastically practicing interpretation of blood gases on patients in the NICU and incorporating principles of infection prevention. The course had sparked a curiosity and enthusiasm in them that he was very exciting to see!

In 2009, we had approximately 100 nurses and 10 medical students or residents from 2 hospitals attend the S.T.A.B.L.E. Course. In 2010, we had 190 nurses and approximately 15 medical students/MDs from 26 hospitals in attendance.

The Guatemalan nurses really enjoyed being able to practice hands on skills with April.
The Guatemalan nurses really enjoyed being able to practice hands-on skills with April.
Jill teaching a small group of nurses how to calculate lab results. A medical student assisted with interpretation.
Jill teaching a small group of nurses how to calculate lab results. A medical student assisted with interpretation.

Shown below are some of the comments made by students who attended the S.T.A.B.L.E. course.


“In 17 years of seeking education in Guatemala, you taught me more in 2 days than I have learned in all these years! Thank you so much! Please come back again.”

“The training was excellent, the practice was very good. I learned very elementary and basic things that if you act immediately, can save the life of patients. If possible, we would like these skills more frequently. Thank you very much, I learned alot.”

“Thank you for the course, it was very good. I hope that it will continue and we wait for you next year”

“Thank you for all of the knowledge, we hope to see you again. Thank you, thank you to all.”

“Thank you for expanding my knowledge and taking into account these activities which helped my professional competency. God bless.”

After learning the S.T.A.B.L.E. Program, 2 nurses returned the next morning with a thank you gift to express their gratitude.
After learning the S.T.A.B.L.E. Program, 2 nurses returned the next morning with a thank you gift to express their gratitude.

Guatemala is in great need of resources for education that are written or recorded in Spanish. They also have a need for items such as Ambu bags, oximeters and cardiac monitors along with any and all types of NICU supplies (tape, duoderm, breast pumping equipment, stethoscopes, blood pressure machines, etc.)

For additional information on how you can help, you may contact the Instructor directly though this link. Contact the Instructor

MATERIALS DONATED FROM THE S.T.A.B.L.E. PROGRAM: 5 Spanish CD-ROM Slide Programs that were given to key educators/physicians in the hospitals who attended in Guatemala City.

1 Cardiac Student Handbook, which was given to a local pediatrician who desires to become a pediatric cardiologist.

Skill practice drawing from a simulated umbilical line.
Skill practice drawing from a simulated umbilical line.
200 nurses from 26 Guatemalan hospitals showed up at a hotel in Guatemala City where we presented the S.T.A.B.L.E. Program and other infant care teaching.
200 nurses from 26 Guatemalan hospitals showed up at a hotel in Guatemala City where we presented the S.T.A.B.L.E. Program and other infant care teaching.
Guatemalan nurses practice hands on skill of bagging an infant.
Guatemalan nurses practice hands on skill of bagging an infant.
Nursery where infants with neurologic issues are managed.
Nursery where infants with neurologic issues are managed.
NICU at Roosevelt Hospital where they care for about 85 infants each day.
NICU at Roosevelt Hospital where they care for about 85 infants each day.
A Beautiful Guatemalan baby in the NICU.
A Beautiful Guatemalan baby in the NICU.
After helping one of the mothers on the OB unit whose baby was in the NICU, she named her baby after me! A very touching moment! Meet little baby Jill!!!
After helping one of the mothers on the OB unit whose baby was in the NICU, she named her baby after me! A very touching moment! Meet little baby Jill!!!

Goma, Democratic Republic of Congo

S.T.A.B.L.E. Program – Goma, Democratic Republic of Congo

  Google Map of the Democratic Republic of Congo
Teaching Team

Cynthia Jensen RN, MSN, CNS, CCRN
S.T.A.B.L.E. Lead Instructor and Neonatal Outreach Educator UCSF Children’s Hospital
Jennifer Parson RN, BSN UCSF Children’s Hospital
David Wanderman MD Department of Pediatrics UCSF Children’s Hospital
Andrea Marmor MD Department of Pediatrics San Francisco General Hospital


Jennifer Parsons teaching how to bag-mask ventilate to one of the physicians

The International Pediatric Outreach Project (IPOP) was founded in 2002 by two pediatricians, Dr. Theodore Ruel and Dr. Sadath Sayeed, with the broad aim of improving the health of children in developing countries through direct and lasting collegial relationships with local health providers. The strategy of IPOP is to assist these providers in addressing what they consider the most pressing problems of child health in their communities through education, research and material support.

Bedside teaching
Reviewing principles of post-resuscitation stabilization with a bedside nurse

Armed with a generous donation of books and supplies from the S.T.A.B.L.E. program, our team from San Francisco travelled to Heal Africa Hospital in Goma, Democratic Republic of Congo (DRC) to provide a week of medical and nursing education with a focus on neonatal resuscitation and stabilization. Approximately 50 students attended the first class and by weeks end we had upwards of 150 participants from Goma and neighboring communities. We were unable to cover the entire S.T.A.B.L.E. learner course for a multitude of reasons (rain, time constraints, availability of translators) but we were able to provide parts of the curriculum and look forward to returning to Congo so we can continue to reinforce what we have taught and also expand on those concepts.

Blood pressure lecture
Blood pressure lecture

The Democratic Republic of Congo is a country that has endured more than its share of strife. War, poverty, disease, gender violence and internal displacement of citizens fleeing conflict are some of the issues that the Congolese deal with on a daily basis. In 2002, the volcanic eruption of Mount Nyiragongo covered Goma with lava making the roads impassable and the soil unusable. Shortly after we left, a plane crashed in a highly populated area in Goma, killing passengers and local residents. 93 people were admitted to Heal Africa Hospital overwhelming the staff and depleting the entire supply of Tetanus vaccine and saline. Even in the face of this crisis, the Heal Africa staff rallied to aid crash victims. Their strength and resilience is amazing and inspiring.

Cynthia Jensen and children at Heal Africa Hospital
Cynthia Jensen and children at Heal Africa Hospital

One member of our team, Jennifer Parson RN, stayed in Congo for 10 weeks to help create an intensive care nursery at Heal Africa Hospital. Jennifer has done an amazing job starting with an empty room that is now a growing unit. She has been training a core group of nurses to care for this special population. IPOP will continue to mentor and support our colleagues with the shared goal of improving outcomes for mothers and babies in Congo.

Heal Africa MDs and mannequin
Heal Africa MDs and mannequin

Materials donated by The S.T.A.B.L.E. Program:

  • 20 Learner Manuals
  • 20 CD-ROM Slide Programs
  • 20 Bedside Quick Reference Cards
  • 20 Physical Exam and Gestational Age Assessment CD-ROMs
  • 2 Cardiac Module CD-ROM Slide Programs
  • 4 Cardiac Module Handbooks

First patient admitted to the NICU

Babies with their Mom�s in the NICU

Physicians rounding in the NICU

 

Infant in ICU

The S.T.A.B.L.E. Program

Not used anymore

S.T.A.B.L.E. is the most widely distributed and implemented neonatal education program to focus exclusively on the post-resuscitation/pre-transport stabilization care of sick infants. Based on a mnemonic to optimize learning, retention and recall of information, S.T.A.B.L.E. stands for the six assessment and care modules in the program: Sugar, Temperature, Airway, Blood pressure, Lab work, and Emotional support. A seventh module, Quality Improvement stresses the professional responsibility of improving and evaluating care provided to sick infants.

First introduced in 1996 in the US and Canada, S.T.A.B.L.E. has grown internationally to include instructor training and courses in more than 45 countries. Currently, there are more than [insert_php] require_once( ABSPATH . ‘/includes/total_students_and_instructors.php’ );
[/insert_php] neonatal healthcare providers have completed a S.T.A.B.L.E. Learner course…