Structured pre-delivery huddles enhance confidence in managing newborns with critical congenital heart disease in the delivery room.

IF 2.4 3区医学 Q2 OBSTETRICS & GYNECOLOGY Journal of Perinatology Pub Date : 2024-12-10 DOI:10.1038/s41372-024-02196-8

Alyssa R Thomas, Caitlin Bowen, Elisa Abdulhayoglu, Elizabeth Brennick, Kendra Woo, Margaret F Everett, Eleonore Valencia, Kristen T Leeman, Simon M Manning, Elisabeth Kaza

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Abstract

Background: Newborns with critical congenital heart disease (CCHD) require specialized delivery room management, but varying experience and knowledge can reduce confidence and impact care.

Methods: A pre-delivery, structured huddle checklist was introduced, addressing team roles, expected physiology, and management plans. PDSA cycles incorporated guidelines and simulation-based education to improve confidence in specialized resuscitation strategies. Surveys were conducted at baseline and 6 months.

Results: Baseline, all-respondent confidence in managing "all types of CCHD" was somewhat confident (median 3/5; IQR 2-4) increasing to moderately confident (4/5; IQR 2-4) at 6 months (p = 0.59). Respondents with 0-3 years' experience showed increased confidence over 6 months in identifying unstable infants (from baseline 24% to 67% moderately/very confident, p = 0.005), prostaglandin E1 needs (from 24% to 62%, p = 0.013) and sedation requirements (from 5% to 33%, p = 0.045).

Conclusion: Structured huddles improved confidence among less experienced team members, emphasizing the importance of shared mental models before CCHD deliveries.

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结构化的产前会议提高了在产房管理新生儿重症先天性心脏病的信心。

背景：新生儿重症先天性心脏病（CCHD）需要专门的产房管理，但不同的经验和知识会降低信心和影响护理。方法：引入了一份交付前、结构化的会议清单，列出了团队角色、预期生理和管理计划。PDSA循环纳入指南和基于模拟的教育，以提高对专业复苏策略的信心。在基线和6个月时进行调查。结果：基线，所有被调查者对管理“所有类型CCHD”的信心都有一定的信心(中位数为3/5；IQR 2-4)增加到中等自信(4/5；6个月时IQR为2-4)（p = 0.59）。具有0-3年经验的受访者在6个月内对识别不稳定婴儿（从基线24%到67%中度/非常自信，p = 0.005），前列腺素E1需求（从24%到62%，p = 0.013）和镇静需求（从5%到33%，p = 0.045）的信心增加。结论：结构化的会议提高了经验不足的团队成员的信心，强调了在CCHD分娩前共享心理模型的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Perinatology 医学-妇产科学

CiteScore

5.40

自引率

6.90%

发文量

284

审稿时长

3-8 weeks

期刊介绍： The Journal of Perinatology provides members of the perinatal/neonatal healthcare team with original information pertinent to improving maternal/fetal and neonatal care. We publish peer-reviewed clinical research articles, state-of-the art reviews, comments, quality improvement reports, and letters to the editor. Articles published in the Journal of Perinatology embrace the full scope of the specialty, including clinical, professional, political, administrative and educational aspects. The Journal also explores legal and ethical issues, neonatal technology and product development. The Journal’s audience includes all those that participate in perinatal/neonatal care, including, but not limited to neonatologists, perinatologists, perinatal epidemiologists, pediatricians and pediatric subspecialists, surgeons, neonatal and perinatal nurses, respiratory therapists, pharmacists, social workers, dieticians, speech and hearing experts, other allied health professionals, as well as subspecialists who participate in patient care including radiologists, laboratory medicine and pathologists.