Hawaii-2012-HB271-Introduced

HOUSE OF REPRESENTATIVES	H.B. NO.	271
TWENTY-SIXTH LEGISLATURE, 2011
STATE OF HAWAII

A BILL FOR AN ACT

MAKING AN APPROPRIATION FOR the development of aDEQUATE NEONATAL RESUSCITATION TRAINING PROGRAMs.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

SECTION 1. The legislature finds that there is concern within the State's community hospitals regarding the lack of neonatal resuscitation professionals in Hawaii and the mortality rate of newborn babies. The Neonatal Resuscitation Program was developed in 1985 by the American Academy of Pediatrics and serves as the "gold standard" for newborn resuscitation. The program is taught at virtually all hospitals in the United States and internationally in more than eighty countries. The program has benefited hospitals by reducing complications and death due to inadequate neonatal resuscitation. The Neonatal Resuscitation Program guidelines recommend: "At every delivery there should be at least one person who can be immediately available to the baby as his or her only responsibility and who is capable of initiating resuscitation. Either this person or someone else who is immediately available should have the skills required to perform a complete resuscitation, including endotracheal intubation and administration of medications. It is not sufficient to have someone "on call" (either at home or in a remote area of the hospital) for newborn resuscitations in the delivery room. When resuscitation is needed, it must be initiated without delay." Approximately ten per cent of babies require resuscitation at birth, and ten to twenty per cent of these babies need extensive resuscitation to survive, requiring advanced skills such as endotracheal intubation, placement of umbilical lines, and administration of medications. If the newborn fails to respond to resuscitation efforts or if the resuscitation is inadequately performed, irreversible damage to multiple organs, including the brain, can occur, with some instances resulting in death.

The legislature further finds that the State's neonatal resuscitation resources are inadequate and that the training and development of neonatal resuscitation teams at neighbor island hospitals will benefit the lives of our newborn children. Adequate training programs should be developed to train pediatric nursing and respiratory therapist staffs and should consist of a prerequisite course, a neonatal resuscitation and stabilization course, and hands-on training.

The prerequisite course consists of the Neonatal Resuscitation Program and the S.T.A.B.L.E program, a one day didactic session that addresses the basics of post-resuscitation and pre-transport management. This training is completed at participating hospitals.

The neonatal resuscitation and stabilization course consists of two phases. Phase one is a one day course that includes didactic lectures and basic skills stations with the primary focus on stabilization of the baby prior to the arrival of the physician. Each hospital will be required to offer two training courses. Pilot courses have already been given at Kona community hospital and Maui memorial medical center. North Hawaii community hospital and Hilo medical center are scheduled for training in November 2011. Similar training has also been done through the Hawaii Computer Human Interaction Lab for Airmed Hawaii in 2009 and Hawaii Life Flight in 2010. Phase two consists of a one day course that focuses on the stabilization of a baby after delivery and prior to transport. This phase will focus on advanced management and skills. Nurses and respiratory therapists who have completed the initial resuscitation team training and community physicians will be the target groups. This course is projected to begin in 2011-2012. In addition, quarterly updates using case scenarios and skills stations will be maintained at all participating centers once initial training has been completed.

For hands-on training, nurses and respiratory therapists will be expected to attend normal low-risk and high-risk deliveries at their home hospitals. Trainees will then go to Kapiolani Medical Center for Women and Children on Oahu to enhance their skills. Because of staffing and funding issues, each trainee would receive one week of training on Oahu with the goal being for them to return periodically as additional funding becomes available in order to improve their clinical management and procedural skills.

The purpose of this Act is to appropriate funds for the development of adequate neonatal resuscitation training programs at Kona community hospitals and Maui county community hospitals.

SECTION 2. There is appropriated out of the general revenues of the State of Hawaii the sum of $37,500 or so much thereof as may be necessary for fiscal year 2011-2012 and the same sum or so much thereof as may be necessary for fiscal year 2012-2013 for the development of adequate neonatal resuscitation training programs, as described in section 1 of this Act, for Kona community hospitals on the island of Hawaii.

SECTION 3. There is appropriated out of the general revenues of the State of Hawaii the sum of $37,500 or so much thereof as may be necessary for fiscal year 2011-2012 and the same sum or so much thereof as may be necessary for fiscal year 2012-2013 for the development of adequate neonatal resuscitation training programs, as described in section 1 of this Act, for Maui county community hospitals.

SECTION 4. The sums appropriated shall be expended by the department of health for the purposes of this Act.

SECTION 5. This Act shall take effect on July 1, 2011.

INTRODUCED BY:	_____________________________