日本未熟児新生児学会雑誌　第19巻　第1号　92～98頁（2007年）

日本未熟児新生児学会雑誌　19(1)：92-98；2007　

受付日：平成17．09．29

受理日：平成18．06．08

NRPをもとにした新生児蘇生講習会の当院における教育効果と問題点

Adoption of a Neonatal Resuscitation Program in a Japanese Hospital：Educational Effectiveness and Considerations

国立成育医療センター　周産期診療部新生児科

Division of Neonatology, Department of Maternal and Perinatal Services, National Center for Child Health and Development

伊藤直樹・中村知夫・大石芳久・高橋重裕・細川真一・藤永英志・塚本桂子・磯島　豪・野矢三樹・花井彩江・和田友香・伊藤裕司

Naoki ITO，Tomoo NAKAMURA，Yoshihisa OISHI，Shigehiro TAKAHASHI， Shinichi HOSOKAWA，Hideshi FUJINAGA，Keiko TSUKAMOTO，Tsuyoshi ISOJIMA， Miki NOYA，Sae HANAI，Yuka WADA，Yushi ITO

Key Words：neonate，resuscitation，education，program evaluation

　当院で2004年から開催しているNeonatal Resuscitation Programをもとにした新生児蘇生講習会の教育効果と問題点を検討した。助産師ら65名を対象に講義と実技の講習会を実施し，簡易試験，到達度自己評価，質問表により評価した。諸外国と同様に教育効果は多大だった。簡易試験の正答率は講習前後で68％から93％に上昇し，知識は向上した。到達度自己評価では，問題解決能力（評価力・判断力・技能）を評価した。講習前は受講者の半数未満しかできなかった判断力や技能が，講習後は評価力，判断力，技能全てが改善し，大半の項目で90％以上の受講者ができていた。さらに講習後1ヶ月で受講者の76％に姿勢の変化を，33％に講習内容の実践での活用を認め，助産師らの積極的な参加により蘇生は円滑に変化した。一方で再履修，日本語の教科書等の教材，日程が問題点であり今後の改善が望まれた。

　We investigated the educational effectiveness of our hospital-based neonatal resuscitation training, which is based on the Neonatal Resuscitation Program（NRP）of the American Academy of Pediatrics and the American Heart Association. Trained neonatologists instructed a neonatal resuscitation training course composed of lectures and practices in 2004 and in 2005. The participants were administered or asked to fill out multiple-choice tests, a self-assessment of their problem-solving abilities, and a questionnaire. The problem-solving abilities were defined as follows：evaluation of the neonate, decisions as to what actions to take, and skills necessary for the action. Sixty-five midwives and nurses participated in the training. Significant educational effects were observed. The increase in knowledge was significant. The average score was 68% for the pretest, and 93% for the posttest. Whereas less than 50% of the participants assessed their decisions and skills as adequate before the training, more than 90% of them assessed their problem-solving abilities had improved afterwards. Furthermore, we observed a change in attitude in 76% of the participants. They cooperated closely with neonatologists in subsequent resuscitations. Thirty-three percent of the participants applied their training experience to their practice and well-coordinated resuscitations were observed during the one-month observation period. Special considerations as to periods between retrainig, study materials such as textbooks translated into Japanese, and schedule for the training course were identified as prerequisites for the dissemination of the program.