C Skåre1, T E Calisch2, E Saeter3, T Rajka4, A M Boldingh5, B Nakstad5, D E Niles6, J Kramer-Johansen1, T M Olasveengen7. 1. Norwegian National Advisory Unit for Prehospital Emergency Care (NAKOS), Department of Anaesthesiology, Oslo University Hospital, University of Oslo, Oslo, Norway. 2. Neonatal Intensive Care Unit, Oslo University Hospital, Oslo, Norway. 3. Department of Anaesthesiology, Oslo University Hospital, Oslo, Norway. 4. Paediatric Intensive Care Unit, Oslo University Hospital, Oslo, Norway. 5. Department of Paediatric and Adolescent Medicine and Institute of Clinical Medicine, University of Oslo, Akershus University Hospital, Lørenskog, Norway. 6. Center for Simulation, Advanced Education and Innovation, The Children`s Hospital in Philadelphia, Philadelphia, PA, USA. 7. Norwegian National Advisory Unit for Prehospital Emergency Care (NAKOS), Department of Anaesthesiology, Oslo University Hospital, Oslo, Norway.
Abstract
BACKGROUND: Approximately 5%-10% of newly born babies need intervention to assist transition from intra- to extrauterine life. All providers in the delivery ward are trained in neonatal resuscitation, but without clinical experience or exposure, training competency is transient with a decline in skills within a few months. The aim of this study was to evaluate whether neonatal resuscitations skills and team performance would improve after implementation of video-assisted, performance-focused debriefings. METHODS: We installed motion-activated video cameras in every resuscitation bay capturing consecutive compromised neonates. The videos were used in debriefings led by two experienced facilitators, focusing on guideline adherence and non-technical skills. A modification of Neonatal Resuscitation Performance Evaluation (NRPE) was used to score team performance and procedural skills during a 7 month study period (2.5, 2.5 and 2 months pre-, peri- and post-implementation) (median score with 95% confidence interval). RESULTS: We compared 74 resuscitation events pre-implementation to 45 events post-implementation. NRPE-score improved from 77% (75, 81) to 89% (86, 93), P < 0.001. Specifically, the sub-categories "group function/communication", "preparation and initial steps", and "positive pressure ventilation" improved (P < 0.005). Adequate positive pressure ventilation improved from 43% to 64% (P = 0.03), and pauses during initial ventilation decreased from 20% to 0% (P = 0.02). Proportion of infants with heart rate > 100 bpm at 2 min improved from 71% pre- vs. 82% (P = 0.22) post-implementation. CONCLUSION: Implementation of video-assisted, performance-focused debriefings improved adherence to best practice guidelines for neonatal resuscitation skill and team performance.
BACKGROUND: Approximately 5%-10% of newly born babies need intervention to assist transition from intra- to extrauterine life. All providers in the delivery ward are trained in neonatal resuscitation, but without clinical experience or exposure, training competency is transient with a decline in skills within a few months. The aim of this study was to evaluate whether neonatal resuscitations skills and team performance would improve after implementation of video-assisted, performance-focused debriefings. METHODS: We installed motion-activated video cameras in every resuscitation bay capturing consecutive compromised neonates. The videos were used in debriefings led by two experienced facilitators, focusing on guideline adherence and non-technical skills. A modification of Neonatal Resuscitation Performance Evaluation (NRPE) was used to score team performance and procedural skills during a 7 month study period (2.5, 2.5 and 2 months pre-, peri- and post-implementation) (median score with 95% confidence interval). RESULTS: We compared 74 resuscitation events pre-implementation to 45 events post-implementation. NRPE-score improved from 77% (75, 81) to 89% (86, 93), P < 0.001. Specifically, the sub-categories "group function/communication", "preparation and initial steps", and "positive pressure ventilation" improved (P < 0.005). Adequate positive pressure ventilation improved from 43% to 64% (P = 0.03), and pauses during initial ventilation decreased from 20% to 0% (P = 0.02). Proportion of infants with heart rate > 100 bpm at 2 min improved from 71% pre- vs. 82% (P = 0.22) post-implementation. CONCLUSION: Implementation of video-assisted, performance-focused debriefings improved adherence to best practice guidelines for neonatal resuscitation skill and team performance.
Authors: Lise Brogaard; Lone Hvidman; Gitte Esberg; Neil Finer; Kristiane R Hjorth-Hansen; Tanja Manser; Ole Kierkegaard; Niels Uldbjerg; Tine B Henriksen Journal: Front Pediatr Date: 2022-02-21 Impact factor: 3.418
Authors: John Madar; Charles C Roehr; Sean Ainsworth; Hege Ersda; Colin Morley; Mario Rüdiger; Christiane Skåre; Tomasz Szczapa; Arjan Te Pas; Daniele Trevisanuto; Berndt Urlesberger; Dominic Wilkinson; Jonathan P Wyllie Journal: Notf Rett Med Date: 2021-06-02 Impact factor: 0.892
Authors: Dana E Niles; Christiane Skåre; Elizabeth E Foglia; Elena Insley; Courtney Cines; Theresa Olasveengen; Lance S Ballester; Anne Ades; Michael Posencheg; Vinay M Nadkarni; Jo Kramer-Johansen Journal: Resusc Plus Date: 2021-02-16