933 EVALUATION BY NON-MEDICAL PERSONNEL OF COMMUNITY HOSPITAL NEONATAL CPR

Abstract

The Vt./N.H. Regional Perinatal Program conducted and evaluated a series of infant CPR courses given for MDs and RNs in eleven hospitals. Each intervention hospital was matched with a control hospital for size, staffing, distance from center, and an objective test of nursing knowledge. A drill and protocol were designed so that performance could be evaluated by non-medical personnel. Pre- and post-drills two weeks apart resulted in complete data from 6 control/intervention pairs. Most common errors included: (1) improper positioning, (2) suctioning with >20 mmHg pressure, (3) no cardiac massage, or when done, (4) lack of support and (5) confusion about rate, (6) failure to intubate or (7) failure to stabilize tube and (8) no ventilation between intubation attempts. Our data indicate that just giving a drill caused an improvement in skills. Both intervention and control hospitals were more likely to do cardiac massage in the post-test. Intervention hospitals increased intubation efforts but with errors. We conclude that: (a) just testing improves skills, (b) CPR courses raise knowledge levels but (c) people need multiple contacts to refine skills and (d) non-medical personnel can effectively evaluate neonatal CPR via a clinical drill.