Resident University of Texas Medical Branch School of Medicine Galveston, Texas, United States
Background: To maintain the highest level of expertise in advanced resuscitation skills for residents and staff in the Neonatal Intensive Care Unit (NICU), an interdisciplinary team has been assembled to identify knowledge gaps and determine comfort levels, ultimately implementing standardized practices. Objective: We aim to assess the learning styles, proficiency levels, and knowledge deficiencies related to the resuscitation skills of NICU staff. Based on these findings, targeted educational and simulation programs will be developed to abet standardization of practices and enhance patient outcomes. Design/Methods: Surveys were conducted before and after implementing neonatal resuscitation training, using the Likert scale, yes/no questions, and free-response questions to assess knowledge and implementation gaps. The team created high-yield educational in-services and simulations to address these gaps. Results: During the pre-intervention studies, specific gaps targeting residents (MD, n=37) and nurses (RN, n=43) were identified. Both groups favored kinesthetic learning (MD 86%, RN 65%), identified knowledge gaps (MD 46%, RN 37%), and felt that a mock code team would improve care (MD 81%, RN 93%). High-yield, brief in-services were developed to target bag-valve-mask ventilation (BMV) with an Ambu bag, airway packs, and code cart utilization. Post-intervention studies included residents (n=42) and nurses (n=29), which yielded a striking decrease in lack of comfort with emergent skills and code situations (MD 59 to 31%, RN 35 to 13%). BMV in-services increased comfort with PEEP valve placement (MD 43 to 71%, RN 79 to 90%) and revealed the continued need for procedural setup regarding the PEEP valve and manometer for both groups. Familiarity with the code cart location (MD 78 to 98%, RN 98% to 100%), supplies (MD 70 to 83%, RN 56 to 79%), and knowing when to grab the code cart (MD 68 to 86%, RN 72 to 83%) increased for both groups. There was an overwhelmingly positive response regarding in-services and impact on patient care with BMV (MD 69%, RN 86%), airway pack (MD 59%, RN 86%), and code carts (MD 45%, RN 83%).
Conclusion(s): The results of the post-intervention surveys showed that structured educational interventions could improve competency and comfort levels in neonatal resuscitation. The surveys revealed significant enhancements in, including but not limited to, airway management, medication administration, and various emergent procedures. By forming an interdisciplinary team, a diverse range of expertise can be harnessed to address the knowledge and confidence gaps, build trust, and promote effective teamwork.
