Hege Ersdal
Biographic Data
| ID | 7604611 |
|---|---|
| NAME | Hege Ersdal |
| GIVEN NAMES | Hege |
| FAMILY NAME | Ersdal |
| SIGNATURE | ERSDAL H |
| AFFILIATIONS | Stavanger University Hospital |
| ORCID | 0000-0002-2795-8564 |
| VERIFIED | Yes |
| TOTAL WORKS | 19 |
| TOTAL CITATIONS | 0 |
| AUTHOR COUNT | 19 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2018 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 0 |
Neonatal resuscitation skills retention among healthcare providers one year after implementation of in situ low-dose high-frequency simulations using innovative tools across two regions in Tanzania
Background The Safer Births Bundle of Care (SBBC) was introduced in five regions in Tanzania to improve the quality of care around birth. Among the interventions was an initiative to train healthcare providers on neonatal resuscitation following the Helping Babies Breathe curriculum, using innovative simulation tools.Objectives This study aimed to assess simulated neonatal resuscitation skills retention and associated factors one year after imple…
Readiness to Provide Neonatal Care Services in 208 Ethiopian Hospitals Prior to Implementation of the Saving Little Lives Program
Introduction: Despite improved health service accessibility, neonatal mortality in Ethiopia remains high at 33 per 1000 live births. Thus, improving health facilities’ readiness across infrastructure, basic amenities, equipment, medications, laboratory services, Kangaroo Mother Care, infection prevention and control, staffing, and guidelines availability is critical for improving the quality of neonatal care and survival. Objective: The aim of th…
Availability and functioning of neonatal care units and neonatal mortality across five regions in Tanzania
BACKGROUND: The neonatal mortality rate in Tanzania has remained persistently high, at 24 deaths per 1000 live births. To halve the current death rate by 2030, the WHO recommends that by 2025, at least 80% of districts should have a neonatal care unit (NCU) and use a continuous positive airway pressure (CPAP) device for respiratory support, among small and sick newborns. This study describes the availability and functioning of NCUs and facility-b…
Impact of Heart Rate Monitoring Using Dry-Electrode ECG Immediately After Birth on Time to Start Ventilation
The use of dry-electrode ECG heart rate monitoring did not change the proportion of newborns that received ventilation within 60 s after birth, but early termination due to employee protests to video recordings rendered the trial inadequately powered to detect a difference. Breathing status was likely a more important determinant of starting ventilation than bradycardia
Acceptability Among Healthcare Providers of In Situ, Low-Dose, High-Frequency Neonatal Resuscitation Simulation Training Using Innovative Tools
Introduction : Newborn mortality is unacceptably high, especially in low- and middle-income countries. The Safer Births Bundle of Care (SBBC) was implemented in Tanzania, including training of healthcare workers on neonatal resuscitation by means of frequent in situ simulation training using improved training tools. We aimed to assess the acceptability of this training model among healthcare providers in selected health facilities under SBBC inte…
Safer Births Bundle of Care” Implementation and Perinatal Impact at 30 Hospitals in Tanzania—Halfway Evaluation
Safer Births Bundle of Care (SBBC) consists of innovative clinical and training tools for improved labour care and newborn resuscitation, integrated with new strategies for continuous quality improvement. After implementation, we hypothesised a reduction in 24-h newborn deaths, fresh stillbirths, and maternal deaths by 50%, 20%, and 10%, respectively. This is a 3-year stepped-wedged cluster randomised implementation study, including 30 facilities…
Neurodevelopmental Outcome at 6 Months Following Neonatal Resuscitation in Rural Tanzania
Early bag-mask ventilation (BMV) administered to non-breathing neonates at birth in the presence of birth asphyxia (interruption of placental blood flow) has reduced neonatal mortality by up to 50% in low- and middle-income countries. The neurodevelopmental outcome of neonates receiving BMV remains unknown. Using the Malawi Developmental Assessment Tool (MDAT), infants who received BMV at birth were assessed at 6 months, evaluating gross motor, f…
Use of Pulse Oximetry during Resuscitation of 230 Newborns—A Video Analysis
In total, 97% of resuscitated newborns had PO applied, in line with resuscitation guidelines. However, the application of PO was time-consuming, and a PO signal was only obtained 5% of the time during positive pressure ventilation
Incomplete Exhalation during Resuscitation—Theoretical Review and Examples from Ventilation of Newborn Term Infants
Incomplete exhalation and the relationship to expiratory time constants have been well described theoretically. We documented examples of incomplete exhalations with increased PEEP-levels during resuscitation of term newborns. We conclude that RFM data from resuscitations can be reviewed for this purpose and that incomplete exhalations should be further explored, as the clinical benefit or risk of harm are not known
Use of Suctioning during Newborn Resuscitation and Its Effects on Heart Rate in a Low-Resource Setting, Tanzania
Suctioning of newborns immediately after birth, as part of delivery room resuscitation, is only recommended if the airway is obstructed. The aim of this study was to describe the use of suctioning during newborn resuscitation among survivors versus those who died within 3 days and potential suction-related heart rate responses and associations to newborn characteristics. This was a retrospective observational study from July 2013 to July 2016 in …
Fetal to Neonatal Heart Rate Transition during Normal Vaginal Deliveries
Documentation of fetal to neonatal heart rate (HR) transition is limited. The aim of the current study was to describe HR changes from one hour before to one hour after normal vaginal deliveries. We conducted a prospective observational cohort study in Tanzania from 1 October 2020 to 30 August 2021, including normal vaginal deliveries with normal neonatal outcomes. HR was continuously recorded from one hour before to one hour after delivery, usin…
Delivery Room ST Segment Analysis to Predict Short Term Outcomes in Near-Term and Term Newborns
ST-segment elevation was commonly seen and not associated with negative outcomes when using one-lead dry-electrode ECG. Other ST-segment abnormalities were associated with prolonged BMV and worse outcome. ECG with appropriate bandwidth and automated analysis may potentially in the future aid in the identification of severely asphyxiated infants
Novel Neonatal Simulator Provides High-Fidelity Ventilation Training Comparable to Real-Life Newborn Ventilation
Face mask ventilation of apnoeic neonates is an essential skill. However, many non-paediatric healthcare personnel (HCP) in high-resource childbirth facilities receive little hands-on real-life practice. Simulation training aims to bridge this gap by enabling skill acquisition and maintenance. Success may rely on how closely a simulator mimics the clinical conditions faced by HCPs during neonatal resuscitation. Using a novel, low-cost, high-fidel…
Comparison of Heart Rate Feedback from Dry-Electrode ECG, 3-Lead ECG, and Pulse Oximetry during Newborn Resuscitation
NeoBeat was faster to place, presented HR more rapidly, and provided feedback on HR for a larger proportion of time during ongoing resuscitation compared to 3-lead ECG and PO
A Randomised Controlled Study of Low-Dose High-Frequency In-Situ Simulation Training to Improve Newborn Resuscitation
Positive pressure ventilation of the non-breathing newborn is a critical and time-sensitive intervention, considered to be the cornerstone of resuscitation. Many healthcare providers working in delivery units in high-resource settings have little opportunity to practise this skill in real life, affecting their performance when called upon to resuscitate a newborn. Low-dose, high-frequency simulation training has shown promise in low-resource sett…
Effectiveness of a Novel Continuous Doppler (Moyo) Versus Intermittent Doppler in Intrapartum Detection of Abnormal Foetal Heart Rate
Background : Intrapartum foetal heart rate (FHR) monitoring is crucial for identification of hypoxic foetuses and subsequent interventions. We compared continuous monitoring using a novel nine-crystal FHR monitor (Moyo) versus intermittent single crystal Doppler (Doppler) for the detection of abnormal FHR. Methods : An unmasked randomised controlled study was conducted in a tertiary hospital in Tanzania (ClinicalTrials.gov Identifier: NCT02790554…
Factors affecting effective ventilation during newborn resuscitation
BACKGROUND: Intrapartum-related hypoxia accounts for 30% of neonatal deaths in Tanzania. This has led to the introduction and scaling-up of the Helping Babies Breathe (HBB) programme, which is a simulation-based learning programme in newborn resuscitation skills. Studies have documented ineffective ventilation of non-breathing newborns and the inability to follow the HBB algorithm among providers. OBJECTIVE: This study aimed at exploring barriers…
Acquiring Knowledge about the Use of a Newly Developed Electronic Fetal Heart Rate Monitor
In an effort to reduce newborn mortality, a newly developed strap-on electronic fetal heart rate monitor was introduced at several health facilities in Tanzania in 2015. Training sessions were organized to teach staff how to use the device in clinical settings. This study explores skilled birth attendants' perceptions and experiences acquiring and transferring knowledge about the use of the monitor, also called Moyo. Knowledge about this learning…
I Was Relieved to Know That My Baby Was Safe”
To increase labor monitoring and prevent neonatal morbidity and mortality, a new wireless, strap-on electronic fetal heart rate monitor called Moyo was introduced in Tanzania in 2016. As part of the ongoing evaluation of the introduction of the monitor, the aim of this study was to explore the attitudes and perceptions of women who had worn the monitor continuously during their most recent delivery and perceptions about how it affected care. This…
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Factors affecting effective ventilation during newborn resuscitation
BACKGROUND: Intrapartum-related hypoxia accounts for 30% of neonatal deaths in Tanzania. This has led to the introduction and scaling-up of the Helping Babies Breathe (HBB) programme, which is a simulation-based learning programme in newborn resuscitation skills. Studies have documented ineffective ventilation of non-breathing newborns and the inability to follow the HBB algorithm among providers. OBJECTIVE: This study aimed at exploring barriers…
Acquiring Knowledge about the Use of a Newly Developed Electronic Fetal Heart Rate Monitor
In an effort to reduce newborn mortality, a newly developed strap-on electronic fetal heart rate monitor was introduced at several health facilities in Tanzania in 2015. Training sessions were organized to teach staff how to use the device in clinical settings. This study explores skilled birth attendants' perceptions and experiences acquiring and transferring knowledge about the use of the monitor, also called Moyo. Knowledge about this learning…
I Was Relieved to Know That My Baby Was Safe”
To increase labor monitoring and prevent neonatal morbidity and mortality, a new wireless, strap-on electronic fetal heart rate monitor called Moyo was introduced in Tanzania in 2016. As part of the ongoing evaluation of the introduction of the monitor, the aim of this study was to explore the attitudes and perceptions of women who had worn the monitor continuously during their most recent delivery and perceptions about how it affected care. This…
Effectiveness of a Novel Continuous Doppler (Moyo) Versus Intermittent Doppler in Intrapartum Detection of Abnormal Foetal Heart Rate
Background : Intrapartum foetal heart rate (FHR) monitoring is crucial for identification of hypoxic foetuses and subsequent interventions. We compared continuous monitoring using a novel nine-crystal FHR monitor (Moyo) versus intermittent single crystal Doppler (Doppler) for the detection of abnormal FHR. Methods : An unmasked randomised controlled study was conducted in a tertiary hospital in Tanzania (ClinicalTrials.gov Identifier: NCT02790554…
Novel Neonatal Simulator Provides High-Fidelity Ventilation Training Comparable to Real-Life Newborn Ventilation
Face mask ventilation of apnoeic neonates is an essential skill. However, many non-paediatric healthcare personnel (HCP) in high-resource childbirth facilities receive little hands-on real-life practice. Simulation training aims to bridge this gap by enabling skill acquisition and maintenance. Success may rely on how closely a simulator mimics the clinical conditions faced by HCPs during neonatal resuscitation. Using a novel, low-cost, high-fidel…
Comparison of Heart Rate Feedback from Dry-Electrode ECG, 3-Lead ECG, and Pulse Oximetry during Newborn Resuscitation
NeoBeat was faster to place, presented HR more rapidly, and provided feedback on HR for a larger proportion of time during ongoing resuscitation compared to 3-lead ECG and PO
A Randomised Controlled Study of Low-Dose High-Frequency In-Situ Simulation Training to Improve Newborn Resuscitation
Positive pressure ventilation of the non-breathing newborn is a critical and time-sensitive intervention, considered to be the cornerstone of resuscitation. Many healthcare providers working in delivery units in high-resource settings have little opportunity to practise this skill in real life, affecting their performance when called upon to resuscitate a newborn. Low-dose, high-frequency simulation training has shown promise in low-resource sett…
Delivery Room ST Segment Analysis to Predict Short Term Outcomes in Near-Term and Term Newborns
ST-segment elevation was commonly seen and not associated with negative outcomes when using one-lead dry-electrode ECG. Other ST-segment abnormalities were associated with prolonged BMV and worse outcome. ECG with appropriate bandwidth and automated analysis may potentially in the future aid in the identification of severely asphyxiated infants
Safer Births Bundle of Care” Implementation and Perinatal Impact at 30 Hospitals in Tanzania—Halfway Evaluation
Safer Births Bundle of Care (SBBC) consists of innovative clinical and training tools for improved labour care and newborn resuscitation, integrated with new strategies for continuous quality improvement. After implementation, we hypothesised a reduction in 24-h newborn deaths, fresh stillbirths, and maternal deaths by 50%, 20%, and 10%, respectively. This is a 3-year stepped-wedged cluster randomised implementation study, including 30 facilities…
Neurodevelopmental Outcome at 6 Months Following Neonatal Resuscitation in Rural Tanzania
Early bag-mask ventilation (BMV) administered to non-breathing neonates at birth in the presence of birth asphyxia (interruption of placental blood flow) has reduced neonatal mortality by up to 50% in low- and middle-income countries. The neurodevelopmental outcome of neonates receiving BMV remains unknown. Using the Malawi Developmental Assessment Tool (MDAT), infants who received BMV at birth were assessed at 6 months, evaluating gross motor, f…
Use of Pulse Oximetry during Resuscitation of 230 Newborns—A Video Analysis
In total, 97% of resuscitated newborns had PO applied, in line with resuscitation guidelines. However, the application of PO was time-consuming, and a PO signal was only obtained 5% of the time during positive pressure ventilation
Incomplete Exhalation during Resuscitation—Theoretical Review and Examples from Ventilation of Newborn Term Infants
Incomplete exhalation and the relationship to expiratory time constants have been well described theoretically. We documented examples of incomplete exhalations with increased PEEP-levels during resuscitation of term newborns. We conclude that RFM data from resuscitations can be reviewed for this purpose and that incomplete exhalations should be further explored, as the clinical benefit or risk of harm are not known
Use of Suctioning during Newborn Resuscitation and Its Effects on Heart Rate in a Low-Resource Setting, Tanzania
Suctioning of newborns immediately after birth, as part of delivery room resuscitation, is only recommended if the airway is obstructed. The aim of this study was to describe the use of suctioning during newborn resuscitation among survivors versus those who died within 3 days and potential suction-related heart rate responses and associations to newborn characteristics. This was a retrospective observational study from July 2013 to July 2016 in …
Fetal to Neonatal Heart Rate Transition during Normal Vaginal Deliveries
Documentation of fetal to neonatal heart rate (HR) transition is limited. The aim of the current study was to describe HR changes from one hour before to one hour after normal vaginal deliveries. We conducted a prospective observational cohort study in Tanzania from 1 October 2020 to 30 August 2021, including normal vaginal deliveries with normal neonatal outcomes. HR was continuously recorded from one hour before to one hour after delivery, usin…
Availability and functioning of neonatal care units and neonatal mortality across five regions in Tanzania
BACKGROUND: The neonatal mortality rate in Tanzania has remained persistently high, at 24 deaths per 1000 live births. To halve the current death rate by 2030, the WHO recommends that by 2025, at least 80% of districts should have a neonatal care unit (NCU) and use a continuous positive airway pressure (CPAP) device for respiratory support, among small and sick newborns. This study describes the availability and functioning of NCUs and facility-b…
Impact of Heart Rate Monitoring Using Dry-Electrode ECG Immediately After Birth on Time to Start Ventilation
The use of dry-electrode ECG heart rate monitoring did not change the proportion of newborns that received ventilation within 60 s after birth, but early termination due to employee protests to video recordings rendered the trial inadequately powered to detect a difference. Breathing status was likely a more important determinant of starting ventilation than bradycardia
Acceptability Among Healthcare Providers of In Situ, Low-Dose, High-Frequency Neonatal Resuscitation Simulation Training Using Innovative Tools
Introduction : Newborn mortality is unacceptably high, especially in low- and middle-income countries. The Safer Births Bundle of Care (SBBC) was implemented in Tanzania, including training of healthcare workers on neonatal resuscitation by means of frequent in situ simulation training using improved training tools. We aimed to assess the acceptability of this training model among healthcare providers in selected health facilities under SBBC inte…
Neonatal resuscitation skills retention among healthcare providers one year after implementation of in situ low-dose high-frequency simulations using innovative tools across two regions in Tanzania
Background The Safer Births Bundle of Care (SBBC) was introduced in five regions in Tanzania to improve the quality of care around birth. Among the interventions was an initiative to train healthcare providers on neonatal resuscitation following the Helping Babies Breathe curriculum, using innovative simulation tools.Objectives This study aimed to assess simulated neonatal resuscitation skills retention and associated factors one year after imple…
Readiness to Provide Neonatal Care Services in 208 Ethiopian Hospitals Prior to Implementation of the Saving Little Lives Program
Introduction: Despite improved health service accessibility, neonatal mortality in Ethiopia remains high at 33 per 1000 live births. Thus, improving health facilities’ readiness across infrastructure, basic amenities, equipment, medications, laboratory services, Kangaroo Mother Care, infection prevention and control, staffing, and guidelines availability is critical for improving the quality of neonatal care and survival. Objective: The aim of th…
Medicine (17 works) · Neonatal Respiratory Health Research (13 works) · Resuscitation (10 works) · Internal Medicine (9 works) · Neonatal resuscitation (9 works) · Anesthesia (8 works) · Global Maternal and Child Health (8 works) · Tanzania (7 works) · Cardiac Arrest and Resuscitation (6 works) · Infant Development and Preterm Care (6 works)