This article was originally posted on the Journal of Neonatal Nurses.
The perinatal and neonatal mortality rates in South Africa are inappropriately high. In order to support an improvement in the standard of neonatal care in the hospitals in Area 2 KZN a Neonatal Experiential Learning Site (NELS) was created. Run by a full time coordinator, it consists of a centralized two week learning block and an outreach support and teaching programme. Thus far there has been improved staff morale, increasing awareness by hospitals of the need to improve neonatal care, improved communication and collaboration between doctors and nurses and improved quality of care. Unfortunately numbers accessing NELS training are inconsistent often including junior staff unable to implement change without senior support. Rapid turnover of staff limits sustainability of change. Ongoing poor staff patient ratios decrease the effectiveness of outreach visits and the ability of staff to implement quality improvement. Ongoing support is imperative to ensure sustainable change. It is crucial for a senior nurse/doctor permanently employed in neonatal care to drive the quality improvement process in each hospital. Support from management is vital. Close liaison with Provincial departments will ensure standardization. Accreditation of neonatal units will encourage compliance with the norms and standards set.