Misty Melendi, Allison E Zanno, Jeffrey Holmes, Micheline Chipman, Anya Cutler, Henry Stoddard, Leah Seften, Anna Gilbert, Mary Ottolini, Alexa Craig, Leah Mallory
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引用次数: 0
Abstract
Objectives: Neonatal resuscitation is a high acuity, low-occurrence (HALO) event and many rural pediatricians report feeling underprepared for these events. We piloted a longitudinal telesimulation (TS) program with a rural hospital's interprofessional delivery room teams aimed at improving adherence to Neonatal Resuscitation Program (NRP®) guidelines and teamwork.
Study design: A TS study was conducted monthly in one rural hospital over a ten month period from November 2020 to August 2021. TS sessions were remotely viewed and debriefed by experts. Sessions were video recorded and assessed using a scoring tool with validity evidence for NRP® adherence. Teamwork was assessed using both TeamSTEPPS 2.0 Team Performance Observation Tool and Mayo High-Performance Teamwork Scale.
Results: We conducted ten TS sessions in one rural hospital. There were 24 total participants, who rotated through monthly sessions, ensuring interdisciplinary team composition was reflective of realistic staffing. NRP® adherence rate for full code scenarios improved from a baseline of 39% to 95%. Compared with baseline data for efficiency, multiple NRP® skills improved (e.g. cardiac lead placement occurred 12x faster). Teamwork scores showed improvement in all domains.
Conclusions: Our results demonstrate that a TS program aimed at improving NRP® and team performance is possible to implement in a rural setting. Our pilot study showed a trend towards improved NRP® adherence, increased skill efficiency, and higher quality teamwork and communication in one rural hospital. Additional research is needed to analyze program efficacy on a larger scale and to understand the impact of training on patient outcomes.
期刊介绍：
The American Journal of Perinatology is an international, peer-reviewed, and indexed journal publishing 14 issues a year dealing with original research and topical reviews. It is the definitive forum for specialists in obstetrics, neonatology, perinatology, and maternal/fetal medicine, with emphasis on bridging the different fields.
The focus is primarily on clinical and translational research, clinical and technical advances in diagnosis, monitoring, and treatment as well as evidence-based reviews. Topics of interest include epidemiology, diagnosis, prevention, and management of maternal, fetal, and neonatal diseases. Manuscripts on new technology, NICU set-ups, and nursing topics are published to provide a broad survey of important issues in this field.
All articles undergo rigorous peer review, with web-based submission, expedited turn-around, and availability of electronic publication.
The American Journal of Perinatology is accompanied by AJP Reports - an Open Access journal for case reports in neonatology and maternal/fetal medicine.
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