287 - The perceived workload of medical doctors and nurses/midwives during neonatal resuscitation

Poster Number: 287
Publication Number: 287.3180

Background: Neonatal resuscitation has been reported to be stressful as perceived by healthcare providers using the National Aeronautics and Space Administration-Task Load Index (NASA-TLX). Indeed, during high acuity deliveries, healthcare providers might perceive increased workload and stress with poorer performance and increased frustration. However, there is little information regarding the perceived workload and associated factors among the healthcare providers including medical doctors (MDs) and nurses/midwives who have differences in training and experiences.

Objective: We aimed to characterize and compare the perceived workload between first-line MDs and nurses/midwives who provided neonatal resuscitation.

Design/Methods: In a prospectively designed, cellphone-based surveillance, perceived workload and stress of first-line MDs and nurses/midwives during neonatal resuscitation was evaluated using a modified multi-dimensional NASA-TLX survey (translated in Chinese) from May 1, 2021 through December 31, 2021 in three Neonatal Intensive Care Units of tertiary hospitals in China. The NASA-TLX survey collects data on mental, physical, temporal demand, performance, effort, and frustration, which were independently rated by participants and collated to a composite score of all dimensions. Demographic factors of the participants, and characteristics of infants and deliveries were also collected for statistical analyses using univariate comparison and multiple linear regression.

Results: There were 410 valid surveys completed by 187 (46%) MDs and 223 (64%) nurses/midwives in this study. Significant differences were noted between MDs and nurses/midwives including working years and dimensional and overall NASA-TLX scores (Table 1). While MDs had lower overall NASA-TLX scores than that of nurses/midwives, both groups had an inverse relationship between the score and neonatal resuscitation simulation training [MDs: β=-10.6, 95% CI(-14.6, -6.6); nurses/midwives: β=-6.0, 95% CI(-10.6, -1.3)] (Table 2). The presence of more team members during resuscitation was positively associated with NASA-TLX scores [MDs: β=1.8, 95% CI(0.6, 2.9); nurses/midwives: β=3.5, 95% CI(2.4, 4.6)]. Other independent factors associated with NASA-TLX scores included year of practice, Apgar score at 1 min and gestational age for MDs and all 4 pre-birth questions asked in nurses/midwives (Table 2).

Conclusion(s): Medical doctors and nurses/midwives attending deliveries had different perception in workload and stress which could be benefited from simulation-based training in neonatal resuscitation.