Keywords
Healthcare Personnel, Hospital, Neonate, Readiness, Resuscitation
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Utomo MT, Sampurna MTA, Widyatama RA et al. Neonatal resuscitation: A cross-sectional study measuring the readiness of healthcare personnel [version 1; peer review: 2 approved with reservations]. F1000Research 2022, 11:520 (https://doi.org/10.12688/f1000research.109110.1)
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Research Article
Neonatal resuscitation: A cross-sectional study measuring the readiness of healthcare personnel
[version 1; peer review: 2 approved with reservations]
PUBLISHED 13 May 2022
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Abstract
Corresponding author:
Mahendra Tri Arif Sampurna
Competing interests:
No competing interests were disclosed.
Grant information:
This work was supported by the Directorate of Research, Technology, and Community Service and the Directorate General of Higher Education, Research, and Technology; Ministry of Education, Culture, Research, and Technology of Indonesia via SIMLITABMAS (Sistem Informasi Manajemen Penelitian dan Pengabdian Kepada Masyarakat) program.
The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Copyright:
© 2022 Utomo MT et al.
This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
How to cite: Utomo MT, Sampurna MTA, Widyatama RA et al. Neonatal resuscitation: A cross-sectional study measuring the readiness of healthcare personnel [version 1; peer review: 2 approved with reservations]. F1000Research 2022, 11:520 (https://doi.org/10.12688/f1000research.109110.1)
First published: 13 May 2022, 11:520 (https://doi.org/10.12688/f1000research.109110.1)
Latest published: 22 May 2023, 11:520 (https://doi.org/10.12688/f1000research.109110.2)
The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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Background
Neonatal mortality is one of the standards of neonatal care. Data from developing countries showed that about 4 million babies die in the neonatal period.1 As a developing country, Indonesia also contributes, with the mortality rate reaching 12.4 per 1,000 live births in 2019.2 The right strategy for neonatal referral and the readiness of the hospital must be assessed to decrease the neonatal mortality rate in Indonesia.3,4
The leading causes of neonatal mortality were prematurity, sepsis, and asphyxia.5–7 These conditions are often related to the requirement of neonatal resuscitation.8,9 Neonatal resuscitation is a series of procedures performed to prevent the morbidity and mortality associated with a hypoxic-ischemic tissue injury (brain, heart, kidney) and restore spontaneous breathing and adequate cardiac output.10,11 The appropriate neonatal resuscitation is believed to increase the survival of neonates and reduce the mortality.12
The neonatal resuscitation service and patient prognosis were strong influence factors in the success of this procedure. Essential tools also must be available and ready to use whenever needed.11,13 The healthcare personnel which play important roles on the neonatal resuscitation must be prepared by several trainings.14 The trainings are expected to increase the healthcare personnel’s capability and confidence in doing neonatal resuscitation.15
To provide optimal services, healthcare personnel must be prepared with both knowledge and experience.16–18 Therefore, the factors that are associated with the knowledge and experience of the healthcare personnel need to be discovered. This study aims to assess the readiness of hospitals by analyzing the knowledge and experience of healthcare personnel in performing neonatal resuscitation.
Methods
Study design and participants
This research has obtained permission from the Ethics Committee of RSUD Dr. Soetomo Surabaya (Letter of Exemption 0335/LOE/301.4.2/II/2021). The data in this study was collected in May 2021 by distributing questionnaires to nurses, midwives, doctors, and residents to determine the level of knowledge and experience of the subject regarding neonatal resuscitation. The researchers met the participants and gave the explanation about the questionnaire in the pediatrics department of each hospital. Subjects in this study have filled out a statement of consent to be involved in this study. To address potential sources of bias, we invited respondents from all types of hospitals (A-D) to participate in our study.
Data collection
This study was conducted in May 2021. The participants filled out the questionnaire for knowledge and experience measurement.19,20 The questionnaire was adopted from Jukkala et al.20 study with their permission. They developed questionnaires for measuring knowledge and experience in hospital settings. The questionnaires were then translated into Indonesian. The questionnaire was validated by several experts in neonatal resuscitation, which confirmed it was comprehensible. After that, the questionnaire was disseminated to 10 nurses to assess the validity and reliability using the bivariate correlation test and alpha-cronbach reliability test.
The resuscitation knowledge questionnaire contained 25 statements which are true or false questions. The participants chose the answer by marking either “true” or “false” in the column provided. The correct answer mark is 1 point and the wrong answer mark is 0 point. We obtained the total score for each subject for further analysis. From the 148 respondents, we excluded 25 participants because they did not meet our criteria. Five respondents were excluded because they do not work at a type A to D hospital. A further 20 respondents were excluded because they were co-assistant. Leaving 123 respondents included for the knowledge analysis in this study.
The resuscitation experience questionnaire contained 23 statements regarding neonatal resuscitation. The participants were asked to choose an answer using a Likert scale from one to five indicating from rarely to often doing the job in the statement. The data from each subject was then totaled for further analysis. From the 89 respondents who filled out the experience questionnaire, 19 respondents were excluded because they did not meet our criteria. Three respondents did not work at a type A to D hospital and 16 respondents were co-assistants. Leaving 70 respondents for the resuscitation experience analysis.
Definitions
Type A–D hospitals are defined by the Regulation of the Minister of Health of the Republic of Indonesia No. 340/MENKES/PER/III/2010.21 The hospital type is classified based on the medical service facilities and their capabilities. For the type A hospitals there must be at least 4 Basic Specialists, 5 Medical Support Specialists, 12 Other Specialists and 13 Sub Specialist Services. Type B hospitals must have at least 4 Basic Specialists, 4 Medical Support Specialists, 8 Other Specialists and 2 Subspecialist Services. Type C hospitals must have at least 4 Basic Specialists and 4 Medical Supporting Specialist Services. Type D hospitals must have at least 2 Basic Specialist Medical Services.
According to the American Academy of Pediatrics (AAP),22 work units in neonatal care are divided into four levels, namely level 1 to level 4. Level 1 is usually carried out to stabilize the condition of term infants with physiologically stable conditions. Level 2 work units are responsible for stabilizing the premature infants and term infants who are physiologically ill. While at level 3, it is necessary to carry out continuous infant stabilization and observation.22 Although there are four levels, in this study we only divided the room into 3 levels. The level 1 consists of the emergency room, baby room, or neonate room, the level 2 consists of a perinatology room, and the level 3 were Neonatal Intensive Care Unit (NICU) or Pediatric Intensive Care Unit (PICU).
Statistical analysis
We provide tables for each answered question for the knowledge and experience questionnaire. For analysis, we use the average of the total knowledge and experience for the comparative analysis. The continuous data was presented as median and interquartile range (IQR). The Mann-Whitney U test and Kruskal Wallis test were used to compare differences of total knowledge or experiences score between the groups for each factor. The Kruskal Wallis test was used for the multi-categorical data. The Mann-Whitney U test was used for the two-categorical data and the post-hoc analysis. Statistically significant was considered using two-sided α less than 0.05. Statistical analysis was done using the IBM SPSS software (version 23, RRID:SCR_016479).
Results
Study participant characteristics
The characteristics of the participants in the study are shown in Table 1.47 For the knowledge questionnaire, the participants mostly worked at type A hospitals (64.2%) and were mostly aged below 30 years. Only one participant was educated in master’s degree and doctoral degree. The participating professions in this study were midwives (37.4%) and nurses (33.3%) and also dominated by women (91.1%). Most of the employees were contract workers, which consists of midwives, nurses, and general practitioners. For the experience questionnaire, the participants mostly worked at type A hospitals (48.6%). Most of the participant’s professions were nurses (45.7%) and the participants were dominated by females (85.7%). Most of the participants had bachelor’s degrees (60%) and the permanent worker (40%) was the most common type of worker.
Table 1. Participant demography and characteristics.
Knowledge questionnaire
Table 2 showed the answers for the knowledge questionnaire. The highest number participants chose false on the statement about chest compression initiation and positive pressure ventilation (87%). Statements about the number of heart rates in infants, infant diagnosis of primary or secondary apnea, the timing of oxygen administration, and the purpose of determining the Apgar score are also considered as hard questions with a high number of participants.
Table 2. Answers of knowledge questionnaire.
ET: Endotracheal; HR: Heart Rate; PPV: Positive Pressure Ventilation.
We found a significant difference (p = 0.007) between male (median 17.00; IQR 15.00–18.00) and female (median 15.00; IQR 14.00–16.00) participants as shown in Table 3. The education and type of professional role are important factors on participants knowledge. The students (which is the same population as residents) (median 17.00; IQR 15.00–18.00) have higher knowledge than the permanent (median 15.00; IQR 13.00–16.50) and contract (median 15.00; IQR 15.00–15.00) workers (p = 0.001). The post-hoc analysis showed a significant difference (p = 0.013) of knowledge between the A type hospital (median 15.00; IQR 15.00–16.00) and the C type hospital (median 14.50; IQR 12.25–15.75).
Table 3. Comparison between participants characteristic and knowledge score.
| Characteristics | Total knowledge score | p-value | ||
|---|---|---|---|---|
| Median | IQR | |||
| Type of Hospital | A | 15.00 | 15.00-16.00 | 0.119 |
| B | 15.00 | 13.00-17.00 | ||
| C | 14.50 | 12.25-15.75 | ||
| D | 15.00 | 13.25-16.75 | ||
| Sex | Male | 17.00 | 15.00-18.00 | 0.007* |
| Female | 15.00 | 14.00-16.00 | ||
| Age (Year) | <30 | 15.00 | 15.00-15.00 | 0.169 |
| 30-40 | 15.00 | 13.75-17.00 | ||
| 40-50 | 16.00 | 14.75-17.25 | ||
| >50 | 13.00 | 12.00-14.00 | ||
| Education | Associate Degree | 15.00 | 14.00-15.00 | 0.009* |
| Bachelor Degree | 16.00 | 14.00-18.00 | ||
| Master Degree | 15.00 | 15.00-15.00 | ||
| Doctoral Degree | 18.00 | 18.00-18.00 | ||
| Type of Profession | Resident | 17.00 | 15.00-18.00 | 0.000* |
| Midwife | 15.00 | 15.00-15.00 | ||
| Nurse | 14.00 | 12.50-16.00 | ||
| General Practitioners | 15.00 | 14.50-17.00 | ||
| Work Experience (Year) | <1 | 15.00 | 15.00-15.00 | 0.481 |
| 1-5 | 16.00 | 13.75-18.00 | ||
| 5-10 | 15.00 | 13.00-16.50 | ||
| 10-15 | 14.00 | 13.00-18.00 | ||
| 15-20 | 14.50 | 12.75-16.00 | ||
| >20 | 15.00 | 14.00-17.50 | ||
| Employment Status | Permanent worker | 15.00 | 13.00-16.50 | 0.001* |
| Contract worker | 15.00 | 15.00-15.00 | ||
| Students | 17.00 | 15.00-18.00 | ||
| Unit Level | Level 1 | 15.00 | 15.00-15.00 | 0.410 |
| Level 2 | 13.50 | 10.50-16.50 | ||
| Level 3 | 15.00 | 13.00-18.00 | ||
| Post Hoc Analysis | ||||
| Type of Hospital | A vs B | 0.757 | ||
| A vs C | 0.013* | |||
| A vs D | 0.463 | |||
| B vs C | 0.261 | |||
| B vs D | 0.799 | |||
| C vs D | 0.376 | |||
Experience questionnaire
The responses to the knowledge questionnaire were shown in Table 2. The majority of participants rarely performed pulse examinations on umbilical cord (40%). The study also revealed that several participants rarely perform endotracheal suctioning (35.7%), umbilical catheterization (34.3%), take blood through an umbilical vein catheter (47.1%), and administer drugs/fluids through an umbilical catheter (35.7%). Most of them were also not experienced in interpreting the results of neonates' blood gases (27/70; 38.6%) as shown in Table 4.
Table 4. Answers of experience questionnaire.
PPV: Positive Pressure Ventilation.
Table 5 showed the comparison between each group’s risk factors on participant resuscitation experience. Types of hospital are associated with the experience of the medical profession (p = 0.026) with type B as the highest experience option. In the post-hoc analysis, we know that there are non-significant differences between type A hospital and type B hospitals (p = 0.618). The significant differences for the experience of the healthcare personnel are between A and D hospitals (p = 0.014) and between B and D hospitals (0.007).
Table 5. Comparison between participants characteristic and experience score.
| Characteristics | Total experience score | p-value | ||
|---|---|---|---|---|
| Median | IQR | |||
| Types of Hospital | A | 85.00 | 70.00-101.00 | 0.026* |
| B | 92.00 | 81.00-98.00 | ||
| C | 81.00 | 68.25-87.00 | ||
| D | 42.00 | 29.00-75.00 | ||
| Sex | Male | 74.00 | 53.25-80.75 | 0.051 |
| Female | 85.00 | 70.75-96.75 | ||
| Age (Year) | <30 | 75.00 | 42.00-86.00 | 0.022* |
| 30-40 | 85.00 | 72.25-101.00 | ||
| 40-50 | 91.00 | 81.50-94.50 | ||
| >50 | 96.00 | 96.00-96.00 | ||
| Education | Associate Degree | 85.00 | 73.75-93.00 | 0.453 |
| Bachelor Degree | 83.00 | 55.75-100.75 | ||
| Master Degree | 65.00 | 60.00-70.00 | ||
| Type of Profession | Resident | 83.00 | 70.00-111.00 | 0.002* |
| Midwife | 83.00 | 54.75-87.00 | ||
| Nurse | 89.50 | 78.75-96.00 | ||
| General Practitioners | 42.00 | 30.00-66.00 | ||
| Work Experience (Year) | <1 | 52.00 | 33.50-74.50 | 0.006* |
| 1-5 | 81.00 | 62.50-105.00 | ||
| 5-10 | 89.00 | 81.00-104.00 | ||
| 10-15 | 85.00 | 81.00-98.00 | ||
| 15-20 | 94.00 | 45.75-101.00 | ||
| >20 | 90.00 | 81.00-95.00 | ||
| Employment Status | Permanent worker | 87.50 | 78.75-95.75 | 0.230 |
| Contract worker | 78.00 | 45.75-88.75 | ||
| Students | 77.50 | 52.00-105.75 | ||
| Unit Level | Level 1 | 74.00 | 42.00-84.50 | 0.002* |
| Level 2 | 78.00 | 64.50-101.50 | ||
| Level 3 | 92.00 | 76.00-99.00 | ||
| Post Hoc Analysis | ||||
| Type of Hospital | A vs B | 0.618 | ||
| A vs C | 0.291 | |||
| A vs D | 0.014* | |||
| B vs C | 0.073 | |||
| B vs D | 0.007* | |||
| C vs D | 0.061 | |||
We also found asignificant difference (p = 0.022) between the ages, seemingly the older age have more experience on neonatal resuscitation. The type of profession also plays an important role in neonatal resuscitation (p = 0.002). The nurses have the highest experience score (median 89.50; IQR 78.75–96.00) and the general practitioners have the lowest experience score (median 42.00; IQR 30.00–66.00). The longer work experience tended to have a higher experience score (p = 0.006) and the second unit level was the unit level with the lowest experience score compared to the first and third level (p = 0.003).
Discussion
A high level of knowledge and experience of neonatal care is the key to the success of the resuscitation team.12,15,20 Our study describes the knowledge and experience of the health care provider in tertiary hospitals in Indonesia. We found the readiness of healthcare personnel was associated with the type of hospital. We found that medical personnel in the type A hospital have better knowledge that the type C hospital. For the experience, the type A and type B hospitals showed more experienced healthcare personnel than the type D hospital. This study also reveals several factors that influence knowledge and experience. Hence, this study may be used as a reference in the neonatal resuscitation guidelines or policies.
Neonatal resuscitation is an action that requires decisive skill which is obtained by knowledge and experience.23 The neonatal resuscitation team training must be conducted in sufficient time to ensure the capability for the healthcare personnel.11,23 The availability of tools is also an important factor of hospital readiness to perform this procedure.13 Type A or type B hospitals have more qualified facilities to perform the neonatal resuscitation. This is the reason why type A and type B hospitals have better experience in performing neonatal resuscitation than type D hospitals. This also indicates that neonatal resuscitation must be done at the type A or type B hospitals since they are more ready to perform the procedure.
Residents have the highest knowledge score among other types of professions. The students also have the highest knowledge score, since they mostly consist of residents. Knowledge of neonatal resuscitation is a competency that must be mastered by residents during their education as a prospective specialist.24,25 Residents have the responsibility to plan treatment according to the patient's condition. Even with supervision, residents are actually expected to have extensive knowledge about the causes, diagnosis, prognosis, complication, and management of neonates.26,27
We found that nurses have the best experience scores among other types of professions. Nursing is a profession that is directly involved in providing services to the patients.16,28,29 In the tertiary hospitals, where there are very large numbers of patients, doctors are often more involved in planning patient management. In this study, almost all general practitioners are young doctors, who just registered as the internship doctors. That may be the reason for their lack of experience. However, the right strategy needs to be implemented to improve the experience for general practitioners, since they will help in handling the newborns later.30
Previous studies have reported the relation between the age and the experience of neonatal resuscitation.18 Experience will be gained after several times doing and practicing the procedure.31,32 This is also the reason why work experience has a significant relation to the experience score. Experienced practitioners were found to be more confident in performing actions on neonatal patients.33,34
We found a significant difference between unit level and the total experience score. Higher unit levels have higher total experience scores. This is because at the level 1 unit, the baby being treated is a normal baby, while the higher level of care is related to more complications suffered by the babies.22,35 The more difficult procedure may not be conducted at the unit level 1 and level 2, while this procedure is often held in the unit level 3.22 However, we did not find any difference in knowledge between the three unit levels. Although most of the treatment in the level one unit is a normal baby, knowledge of signs of severity and early treatment is important at all levels.36
Additional training using The Newborn Resuscitation Manual from the United Kingdom with skill demonstrations and scenarios using mannequins have been proven to increase the level of knowledge of nurses, doctors, resident doctors, and specialists in Northern Nigeria.19 To increase personal experience, the health care providers need to practice each step of resuscitation.37 Routine training may be an important indicator in determining the hospital's readiness to conduct the neonatal resuscitation.38 Training on the steps of neonatal resuscitation, especially in the steps of palpating umbilical cord pulse, endotracheal suctioning, endotracheal intubation, umbilical catheter placement, taking blood through an umbilical vein catheter, administering drugs/fluids through an umbilical catheter, and interpreting neonatal blood gas results, must be a concern and require more intense training since most of the research subjects in this study rarely perform them.39,40
Endotracheal intubation in neonates is rarely done because of the high level of difficulty and high risk of an adverse event for the procedure.40,41 Even for the skilled healthcare personnel, sometimes they still need to do several attempts until the intubation can enter the trachea of the neonate.38,41 The placement of an umbilical catheter, blood collection, and administration of drugs through the umbilical vein are rarely done, possibly because of its potential to be a risk factor of sepsis.42,43 More practice with evaluation are needed to increase the healthcare personnel confidence in doing the neonatal resuscitation.44–46
Research strengths and limitation
These findings may provide additional information to the guidelines of healthcare personnel training and qualifications. The participants joined this research voluntarily and were given brief socialization to make sure of the comprehension of the questionnaire to decrease risk of bias. However, several limitations exist in our study. First, the number of research subjects was reduced by the COVID-19 pandemic. We did consecutive sampling rather than random sampling which is more applicable. Second, we did not assess how many times the participants have joined the neonatal resuscitation training. The previous training may be associated with the knowledge and experience score of the participants.
Conclusion
The success of neonatal resuscitation is influenced by the readiness of the hospital, which can be seen through indicators of the level of knowledge and experience of the healthcare personnel. In this study, we found that the healthcare personnel from type A and type B hospitals are more experienced than the type D hospital in conducting neonatal resuscitation. We suggest that the type D hospital or other primary care must refer the neonate if there is the need for neonatal resuscitation. Additional neonatal resuscitation training is necessary to increase the knowledge and experience of the healthcare personnel. Finally, larger observational studies with multi-center approaches need to be conducted to confirm our findings.
Data availability
Underlying data
Figshare: Neonatal Resuscitation: Measuring The Readiness of Healthcare Personnel, https://doi.org//10.6084/m9.figshare.18865418.47
The project contains the following underlying data:
Data are available under the terms of the Creative Commons Attribution 4.0 International license (CC-BY 4.0).
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CITE
how to cite this article
Utomo MT, Sampurna MTA, Widyatama RA et al. Neonatal resuscitation: A cross-sectional study measuring the readiness of healthcare personnel [version 1; peer review: 2 approved with reservations]. F1000Research 2022, 11:520 (https://doi.org/10.12688/f1000research.109110.1)
NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article.
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Version 1
VERSION 1
PUBLISHED 13 May 2022
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How to cite this report:
Bhat YR. Reviewer Report For: Neonatal resuscitation: A cross-sectional study measuring the readiness of healthcare personnel [version 1; peer review: 2 approved with reservations]. F1000Research 2022, 11:520 (https://doi.org/10.5256/f1000research.120572.r140368)
The direct URL for this report is:
https://f1000research.com/articles/11-520/v1#referee-response-140368
https://f1000research.com/articles/11-520/v1#referee-response-140368
NOTE: it is important to ensure the information in square brackets after the title is included in this citation.
Reviewer Report 13 Jul 2022
Approved with Reservations
VIEWS 14
The article ‘Neonatal resuscitation: A cross-sectional study measuring the readiness of healthcare personnel” addresses the readiness of healthcare personnel with regard to the much needed topic on neonatal resuscitation. This study used questionnaire in 4 different types of hospitals. They
... Continue reading
CITE
HOW TO CITE THIS REPORT
Bhat YR. Reviewer Report For: Neonatal resuscitation: A cross-sectional study measuring the readiness of healthcare personnel [version 1; peer review: 2 approved with reservations]. F1000Research 2022, 11:520 (https://doi.org/10.5256/f1000research.120572.r140368)
The direct URL for this report is:
https://f1000research.com/articles/11-520/v1#referee-response-140368
https://f1000research.com/articles/11-520/v1#referee-response-140368
NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article.
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Author Response 26 May 2023Mahendra Tri Arif Sampurna, Department of Pediatrics, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya, 60132, Indonesia26 May 2023Author ResponseWe are very thankful for your availability and willingness to help us to become our reviewer on our manuscript entitled "Neonatal Resuscitation: A cross-sectional study measuring the readiness of healthcare ... Continue reading
COMMENTS ON THIS REPORT
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Author Response 26 May 2023Mahendra Tri Arif Sampurna, Department of Pediatrics, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya, 60132, Indonesia26 May 2023Author ResponseWe are very thankful for your availability and willingness to help us to become our reviewer on our manuscript entitled "Neonatal Resuscitation: A cross-sectional study measuring the readiness of healthcare ... Continue reading
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How to cite this report:
Kooi EMW. Reviewer Report For: Neonatal resuscitation: A cross-sectional study measuring the readiness of healthcare personnel [version 1; peer review: 2 approved with reservations]. F1000Research 2022, 11:520 (https://doi.org/10.5256/f1000research.120572.r137948)
The direct URL for this report is:
https://f1000research.com/articles/11-520/v1#referee-response-137948
https://f1000research.com/articles/11-520/v1#referee-response-137948
NOTE: it is important to ensure the information in square brackets after the title is included in this citation.
Reviewer Report 11 Jul 2022
Elisabeth M W Kooi,
University Medical Center Groningen, Beatrix Children's Hospital, Division of Neonatology, University of Groningen, Groningen, The Netherlands
Approved with Reservations
VIEWS 20
This study is an important attempt to receive more insight in resuscitation readiness of various levels of staff in Indonesian hospitals of several levels. A questionnaire was developed and tested in ten nurses and then send out to a large
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HOW TO CITE THIS REPORT
Kooi EMW. Reviewer Report For: Neonatal resuscitation: A cross-sectional study measuring the readiness of healthcare personnel [version 1; peer review: 2 approved with reservations]. F1000Research 2022, 11:520 (https://doi.org/10.5256/f1000research.120572.r137948)
The direct URL for this report is:
https://f1000research.com/articles/11-520/v1#referee-response-137948
https://f1000research.com/articles/11-520/v1#referee-response-137948
NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article.
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Author Response 26 May 2023Mahendra Tri Arif Sampurna, Department of Pediatrics, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya, 60132, Indonesia26 May 2023Author ResponseWe are very thankful for your availability and willingness to help us to become our reviewer on our manuscript entitled "Neonatal Resuscitation: A cross-sectional study measuring the readiness of healthcare ... Continue reading
COMMENTS ON THIS REPORT
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Author Response 26 May 2023Mahendra Tri Arif Sampurna, Department of Pediatrics, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya, 60132, Indonesia26 May 2023Author ResponseWe are very thankful for your availability and willingness to help us to become our reviewer on our manuscript entitled "Neonatal Resuscitation: A cross-sectional study measuring the readiness of healthcare ... Continue reading
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