Neonatal-Perinatal Medicine Fellow University of Mississippi Medical Center Pearl, Mississippi, United States
Background: Neonatal resuscitation is guided by Neonatal Resuscitation Program (NRP) algorithms. However, human factors affect resuscitations especially where they occur infrequently. Video recording used during resuscitation events demonstrates that deviations from resuscitation guidelines are common. Additionally, code documentation is prone to inaccuracies. Objective: Our long-term hypothesis is that the use of an automated resuscitation recorder (ARR) will improve both adherence to NRP algorithms and code documentation. The purpose of this study was to determine the feasibility of the use of the ARR in neonatal resuscitation. Design/Methods: We performed a mixed methodology, simulation-based feasibility study using a convenience sample of simulated code events mimicking NRP training scenarios. We developed the ARR application with two main features: event recording and voice guidance. We performed 10 simulated code events with 5 team members for each resuscitation. Resuscitation teams were oriented to the ARR which was used by each team during the simulation. We collected data via initial demographics survey, video recording, ARR generated code summary, and post-resuscitation survey evaluating comfort and satisfaction with ARR use. We utilized grading tools for NRP adherence (NRP) and accuracy of code documentation (RDP) with scores converted into percentage correct for analysis. We analyzed the post-resuscitation survey in two ways: (1) using the ordinal ratings from the 10 Likert scale questions, and (2) text mining from the open-ended text question. Results: Summary statistics by grading tool (NRP or RDP) were computed. For the NRP assessment: median = 68% range 60-76%. For the RDP assessment: median = 77.5% range 55-90%. When ordinal ratings for Likert data were reviewed 47% were agree (237/500) and 36% were strongly agree (180/500) with only 0.6% (3/500) answering strongly disagree (Figure 1). A word cloud comparing the frequencies of words from the open-ended text question is shown in Image 1.
Conclusion(s): This study demonstrated feasibility of ARR use during neonatal resuscitation. The median scores for NRP and RDP tools are consistent with passing scores. Post-resuscitation survey data shows that people felt comfortable with ARR use while highlighting areas for improvement. A pilot study comparing ARR use with current standard of care is the next step in our research.
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