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please i need your help doctors!

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Hello I am a pediatrician )NICU) from Libya, I would like to ask about some important things to this specialty We are still in Libya at the beginning of the road in this specialty and missing a lot We do not have a great attention to international standards and we still , I mean, most of the doctors , do not know how to evaluate our situation and where to begin. My questions is .. What kind of methods and fundamentals of how to set up research or evaluation and what the important issues that we must be covered For example .. How to assess how to assess our building structure( intensive care unit )and their relationship to diseases ? ? How do I assess dr-pt relationship and degree of satisfaction? .. but how do I start? I hope I explained my questions enough .

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Thanks for posting your questions here, I hope you will get some valuable input from several members.

Starting from scratch with setting up a structure for clinical workflows and research is a major task.

The first and immediate thought that comes into my mind is to begin with simple things and add more complicated aspects as time goes.

I will try to share more thoughts, I just need to think it over first.

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The first that comes into my mind is that you and your colleagues in Libya need to organise yourselves, in a national society.
The main reason I see is that despite current ”evidence” for this and that, you will need to bring knowledge and experience into your context.
In a national society, you will be able to do this, and also set priorities, what projects and issues that are most important.

A national society will also facilitate development of national guidelines, training programs of neonatal fellows, arrange postgraduate meetings, help to set “work flows” between NICUs and other health care facilities etc-etc.


My second and principal thought for all your work is… start simple!
For example: you probably want some system for collection and registration of morbidity and mortality data. Don’t begin to complicated and aim to register “everything”. If you manage to get national data on NICU admissions and their infant gender, gestational age, birth weight, a handful diagnoses (yes/no, coded as ICD10-codes http://www.icd10data.com/ICD10CM/Codes/P00-P96), and mortality, that would be a good start.

Regarding data collection: contact Vermont Oxford Network (http://www.vtoxford.org/) or dr Ian Callander, an Australian neonatologist, who has developed “Neonatal Database” http://home.iprimus.com.au/callanders/ and http://www.jcdr.net/neodb/NeoDB_Questionaire.asp )


When it comes to specific domains of neonatal care, a few topics would be worth to explore early:

  • Promotion of nasal CPAP (as it can potentially reduce the need for mechanical ventilation)
  • Identification and (light) treatment of jaundice
  • Infection control and prevention
  • Nutrition, in particular how to promote breast feeding and the use of breast milk for preterms
  • Kangoroo (skin-to-skin) care and parental involvement

You have a journey to make in Libya, but I am hope you will be able to learn from colleagues around the world to develop your neonatal care fast and efficiant.


My best and warmest wishes, Stefan

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I think that you have to hold the lecture for your staff about nurse care, hand hygiene, oxygen toxicity, resuscitation, NCPAP, etc. . And, when you are working , talk to the nurses at the same time all about the baby that you just examine, relationship with  parents and tell them that put themself in the positions of parents. Any change needs the time, and  if you have to determine,  the results will come.


Best regards



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You may want to look at the resources via the American Academy of Pediatrics for some of your education needs.

Along w/ Resuscitation, the STABLE program (stabilization of the ill newborn) & a multi-part Perinatal Continuing Education Program are under the AAP umbrella. Both programs are very good & would be valuable in community based care centers as well as tertiary care centers.

Regards, Gayle

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