Christiane Skåre1, Anne Marthe Boldingh2, Jo Kramer-Johansen3, Tor Einar Calisch4, Britt Nakstad2, Vinay Nadkarni5, Theresa M Olasveengen6, Dana E Niles7. 1. Norwegian National Advisory Unit for Prehospital Emergency Care (NAKOS) and Department of Anaesthesiology, Oslo University Hospital and University of Oslo, Oslo, Norway. Electronic address: christiane.skare@medisin.uio.no. 2. Department of Paediatric and Adolescent Medicine and Institute of Clinical Medicine, University of Oslo and Akershus University Hospital, Lørenskog, Norway. 3. Norwegian National Advisory Unit for Prehospital Emergency Care (NAKOS) and Department of Anaesthesiology, Oslo University Hospital and University of Oslo, Oslo, Norway. 4. Neonatal Intensive Care Unit, Oslo University Hospital, Oslo, Norway. 5. Department of Anesthesia, Critical Care and Pediatrics, University of Pennsylvania Perelman School of Medicine, The Children's Hospital of Philadelphia, Philadelphia, USA. 6. Department of Anaesthesiology, Oslo University Hospital, Oslo, Norway. 7. Center for Simulation, Advanced Education and Innovation, The Children`s Hospital in Philadelphia, Philadelphia, USA.
Abstract
AIM: Providers caring for newly born infants require skills and knowledge to initiate prompt and effective positive pressure ventilation (PPV) if the newborn does not breathe spontaneously after birth. We hypothesized implementation of high frequency/short duration deliberate practice training and post event video-based debriefings would improve process of care and decreases time to effective spontaneous respiration. METHODS: Pre- and post-interventional quality study performed at two Norwegian university hospitals. All newborns receiving PPV were prospectively video-recorded, and initial performance data guided the development of educational interventions. A priori primary outcome was changed from process of care using the Neonatal Resuscitation Performance Evaluation (NRPE) score to time to effective spontaneous respiration as the NRPE score could only be obtained from one site due to lack of staff resources. RESULTS: Over 12 months, 297 PPV-Refreshers and 52 performance debriefings were completed with 227 unique providers attending a PPV-Refresher and 93 unique providers completed a debriefing. We compared 102 PPV-events pre- to 160 PPV-events post-bundle implementation. The time to effective spontaneous respiration decreased from median (95% confidence interval) 196 (140-237) to 144 (120-163) s, p = 0.010. The NRPE-score increased significantly from median 77% (75-81) pre- to 89% (86-92) post-implementation, p < 0.001. There were no significant differences in time to heart rate >100 beats/min or number of newborns transferred to intensive care. CONCLUSION: High frequency/short duration deliberate practice PPV psychomotor training combined with performance-focused team debriefings using video recordings of actual resuscitations may improve time to effective spontaneous breathing and adherence to guidelines during real neonatal resuscitations.
AIM: Providers caring for newly born infants require skills and knowledge to initiate prompt and effective positive pressure ventilation (PPV) if the newborn does not breathe spontaneously after birth. We hypothesized implementation of high frequency/short duration deliberate practice training and post event video-based debriefings would improve process of care and decreases time to effective spontaneous respiration. METHODS: Pre- and post-interventional quality study performed at two Norwegian university hospitals. All newborns receiving PPV were prospectively video-recorded, and initial performance data guided the development of educational interventions. A priori primary outcome was changed from process of care using the Neonatal Resuscitation Performance Evaluation (NRPE) score to time to effective spontaneous respiration as the NRPE score could only be obtained from one site due to lack of staff resources. RESULTS: Over 12 months, 297 PPV-Refreshers and 52 performance debriefings were completed with 227 unique providers attending a PPV-Refresher and 93 unique providers completed a debriefing. We compared 102 PPV-events pre- to 160 PPV-events post-bundle implementation. The time to effective spontaneous respiration decreased from median (95% confidence interval) 196 (140-237) to 144 (120-163) s, p = 0.010. The NRPE-score increased significantly from median 77% (75-81) pre- to 89% (86-92) post-implementation, p < 0.001. There were no significant differences in time to heart rate >100 beats/min or number of newborns transferred to intensive care. CONCLUSION: High frequency/short duration deliberate practice PPV psychomotor training combined with performance-focused team debriefings using video recordings of actual resuscitations may improve time to effective spontaneous breathing and adherence to guidelines during real neonatal resuscitations.
Authors: Natalie Batey; Caroline Henry; Shalabh Garg; Michael Wagner; Atul Malhotra; Michel Valstar; Thomas Smith; Don Sharkey Journal: Pediatr Res Date: 2022-03-03 Impact factor: 3.756
Authors: Veerle Heesters; Ruben Witlox; Henriette A van Zanten; Sophie J Jansen; Remco Visser; Veerle Heijstek; Arjan B Te Pas Journal: Front Pediatr Date: 2022-08-04 Impact factor: 3.569
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