Use of Simulation-Based Skill Acquisition Instruction (Ssai) for Manual Mask Ventilation (MMV) Improves the Ability of Neonatal Resuscitation Program (NRP) Providers to Deliver and Retain Effective MMV Skills (original) (raw)
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Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 2012
ACADEMIC EMERGENCY MEDICINE 2012; 19: 577–585 © 2012 by the Society for Academic Emergency MedicineACADEMIC EMERGENCY MEDICINE 2012; 19: 577–585 © 2012 by the Society for Academic Emergency MedicineAbstractObjectives: The objective was to determine if a medical simulation-based neonatal resuscitation educational intervention is a more effective teaching method than the current emergency medicine (EM) curriculum at one 4-year EM residency program.Methods: A prospective, randomized study of second-, third-, and fourth-year EM residents was performed. Of 36 potential subjects, 27 residents were enrolled. Each resident was assessed at baseline and after the intervention using 1) a questionnaire to evaluate confidence in leading adult, pediatric, and neonatal resuscitation and prior neonatal resuscitation experience and 2) a neonatal resuscitation simulation scenario in which each participant was the code leader to evaluate knowledge and skills. Assessments were digitally recorded and reviewed independently by two Neonatal Resuscitation Program (NRP) instructors using a validated neonatal resuscitation scoring tool. Controls (15 participants) received the current EM curriculum. The intervention group (12 participants) experienced an educational session, which incorporated didactics, skills station, and medical simulation about neonatal resuscitation. Outcomes measured included changes in overall neonatal resuscitation score, number of critical actions, time to initial steps of neonatal resuscitation, and changes in confidence level leading neonatal resuscitation.Results: Baseline neonatal resuscitation scores were similar for the control and intervention groups. At the final assessment, the intervention group’s neonatal resuscitation score improved (p = 0.016) and the control group’s score did not. The intervention group performed 2.31 more critical actions overall and the time to achieve warming (p = 0.0002), drying (p < 0.0001), tactile stimulation (p = 0.002), and placing a hat on the patient (p <0.0001) were also improved compared to controls. At the baseline assessment, 80% of the control group and 75% of the intervention group reported being “not at all confident” in leading neonatal resuscitation. At the final assessment, the proportion of residents who were “not at all confident” leading neonatal resuscitation decreased to 35% in the intervention group compared to 67% of the control group. The majority of the intervention group (65%) reported an increased level of confidence in leading neonatal resuscitation.Conclusions: Medical simulation can be an effective tool to assess the knowledge and skills of EM residents in neonatal resuscitation. Our simulation-based educational intervention significantly improved EM residents’ knowledge and performance of the critical initial steps in neonatal resuscitation. A medical simulation-based educational intervention may be used to improve EM residents’ knowledge and performance with neonatal resuscitation.Objectives: The objective was to determine if a medical simulation-based neonatal resuscitation educational intervention is a more effective teaching method than the current emergency medicine (EM) curriculum at one 4-year EM residency program.Methods: A prospective, randomized study of second-, third-, and fourth-year EM residents was performed. Of 36 potential subjects, 27 residents were enrolled. Each resident was assessed at baseline and after the intervention using 1) a questionnaire to evaluate confidence in leading adult, pediatric, and neonatal resuscitation and prior neonatal resuscitation experience and 2) a neonatal resuscitation simulation scenario in which each participant was the code leader to evaluate knowledge and skills. Assessments were digitally recorded and reviewed independently by two Neonatal Resuscitation Program (NRP) instructors using a validated neonatal resuscitation scoring tool. Controls (15 participants) received the current EM curriculum. The intervention group (12 participants) experienced an educational session, which incorporated didactics, skills station, and medical simulation about neonatal resuscitation. Outcomes measured included changes in overall neonatal resuscitation score, number of critical actions, time to initial steps of neonatal resuscitation, and changes in confidence level leading neonatal resuscitation.Results: Baseline neonatal resuscitation scores were similar for the control and intervention groups. At the final assessment, the intervention group’s neonatal resuscitation score improved (p = 0.016) and the control group’s score did not. The intervention group performed 2.31 more critical actions overall and the time to achieve warming (p = 0.0002), drying (p < 0.0001), tactile stimulation (p = 0.002), and placing a hat on the patient (p <0.0001) were also improved compared to controls. At the baseline assessment, 80% of the control group and 75% of the intervention group reported being “not at all confident” in leading neonatal resuscitation. At the final assessment, the proportion of residents who were “not at all confident” leading neonatal resuscitation decreased to 35% in the intervention group compared to 67% of the control group. The majority of the intervention group (65%) reported an increased level of confidence in leading neonatal resuscitation.Conclusions: Medical simulation can be an effective tool to assess the knowledge and skills of EM residents in neonatal resuscitation. Our simulation-based educational intervention significantly improved EM residents’ knowledge and performance of the critical initial steps in neonatal resuscitation. A medical simulation-based educational intervention may be used to improve EM residents’ knowledge and performance with neonatal resuscitation.
Performances of low level hospital health caregivers after a neonatal resuscitation course
Italian Journal of Pediatrics, 2016
Background: High fidelity simulation has been executed to allow the evaluation of technical and non-technical skills of health caregivers. Our objective was to assess technical and non-technical performances of low level hospitals health caregivers who attended a Neonatal Resuscitation course using high fidelity simulation in a standard-setting scenario. Methods: Twenty-three volunteers were asked to manage a simple scenario (infant with secondary apnea) after the course. Technical and non-technical skills were assessed by using previously published scores. Performances were assessed during the scenario and after 2 months by filmed video recordings. Results: Sixteen (69.5%) participants failed to pass the minimum required technical score. Staff experience and participation in previous courses were associated to higher score in technical and non-technical skills, while working in level I or II hospitals did not affect the scores. Previous experience in neonatal resuscitation requiring positive pressure ventilation was associated to better non-technical performance. Technical and non-technical scores were significantly correlated (r = 0.67, p = 0.0005). Delayed and direct evaluation of technical skills provided the same scores. Conclusions: A neonatal resuscitation course, performed by using a high fidelity simulation manikin, had a limited impact on technical and non-technical skills of participants working in low level hospitals. Training programs should be tailored to the participants' professional background and to the more relevant sessions.
Advances in Simulation, 2022
Background: Annually, 1.5 million intrapartum-related deaths occur; fresh stillbirths and early newborn deaths. Most of these deaths are preventable with skilled ventilation starting within the first minute of life. Helping Babies Breathe is an educational program shown to improve simulated skills in newborn resuscitation. However, translation into clinical practice remains a challenge. The aim was to describe changes in clinical resuscitation and perinatal outcomes (i.e., fresh stillbirths and 24-h newborn deaths) after introducing a novel simulator (phase 1) and then local champions (phase 2) to facilitate ongoing Helping Babies Breathe skill and scenario simulation training. Methods: This is a 3-year prospective before/after (2 phases) clinical observational study in Tanzania. Research assistants observed all deliveries from September 2015 through August 2018 and recorded labor/newborn information and perinatal outcomes. A novel simulator with automatic feedback to stimulate self-guided skill training was introduced in September 2016. Local champions were introduced in October 2017 to motivate midwives for weekly training, also team simulations. Results: The study included 10,481 births. Midwives had practiced self-guided skill training during the last week prior to a real newborn resuscitation in 34% of cases during baseline, 30% in phase 1, and 71% in phase 2. Most real resuscitations were provided by midwives, increasing from 66% in the baseline, to 77% in phase 1, and further to 83% in phase 2. The median time from birth to first ventilation decreased between baseline and phase 2 from 118 (85-165) to 101 (72-150) s, and time pauses during ventilation decreased from 28 to 16%. Ventilations initiated within the first minute did not change significantly (13-16%). The proportion of high-risk deliveries increased during the study period, while perinatal mortality remained unchanged. Conclusions: This study reports a gradual improvement in real newborn resuscitation skills after introducing a novel simulator and then local champions. The frequency of trainings increased first after the introduction of motivating champions. Time from birth to first ventilation decreased; still, merely 16% of newborns received ventilation within the first minute as recommended. This is a remaining challenge that may require more targeted team-scenario training and quality improvement efforts to improve.
2000
Objectives. Acquisition and maintenance of the skills necessary for successful resuscitation of the neonate are typically accomplished by a combination of completion of standardized training courses using textbooks, videotape, and manikins together with active participation in the resuscitation of human neonates in the real delivery room. We developed a simulation-based training program in neonatal resuscitation (NeoSim) to bridge the gap between textbook and real life and to assess trainee satisfaction with the elements of this program.
Children, 2022
Globally, intrapartum-related complications account for approximately 2 million perinatal deaths annually. Adequate skills in neonatal resuscitation are required to reduce perinatal mortality. NeoNatalie Live is a newborn simulator providing immediate feedback, originally designed to accomplish Helping Babies Breathe training in low-resource settings. The objectives of this study were to describe changes in staff participation, skill-training frequency, and simulated ventilation quality before and after the introduction of “local motivators” in a rural Tanzanian hospital with 4000–5000 deliveries annually. Midwives (n = 15–27) were encouraged to perform in situ low-dose high-frequency simulation skill-training using NeoNatalie Live from September 2016 through to August 2018. Frequency and quality of trainings were automatically recorded in the simulator. The number of skill-trainings increased from 688 (12 months) to 8451 (11 months) after the introduction of local motivators in Oct...
Acta Paediatrica, 2017
The use of simulation-based team training in neonatal resuscitation has increased in Sweden during the last decade, but no formal evaluation of this training method has been performed. This study evaluated the effect of simulation-based team training on the self-assessed ability of personnel to perform neonatal resuscitation. Methods: We evaluated a full-day simulation-based team training course in neonatal resuscitation, by administering a questionnaire to 110 physicians, nurses and midwives before and after the training period. The questionnaire focused on four important domains: communication, leadership, confidence and technical skills. The study was carried out in Sweden from 2005-2007. Results: The response rate was 84%. Improvements in the participants´ self-assessed ability to perform neonatal resuscitation were seen in all four domains after training (p < 0.001). Professionally inexperienced personnel showed a significant improvement in the technical skills domain compared to experienced personnel (p = 0.001). No differences were seen between professions or time since training in any of the four domains. Personnel with less previous experience with neonatal resuscitation showed improved confidence (p = 0.007) and technical skills (p = 0.003). Conclusion: A full-day course on simulation-based team training with video-supported debriefing improved the participants' self-assessed ability to perform neonatal resuscitation.
2016
Teamwork and communication in clinical practice improves with simulation using the TeamSTEPPS program. However, there is limited research about simulation efficacy for improving neonatal resuscitation through enhanced communication. Based on a needs assessment and literature review specific to quality improvement strategies for neonatal resuscitation, an enhanced neonatal resuscitation provider (NRP) course was infused with TeamSTEPPS communication strategies, and an NRP case was adopted for simulation training. Also, utilizing clinician feedback, the flow of the resuscitation documentation was revised. The purpose of this project was to evaluate the perceived level of confidence, satisfaction, and communication skills in nurses performing neonatal resuscitation following the implementation of simulation into NRP training. The simulation exercise was guided by the National League for Nursing / Jeffries Simulation Framework (NLN/JFS). A purposeful sample of nurses (N=61) in a tertiar...