A Randomised Controlled Study of Low-Dose High-Frequency In-Situ Simulation Training to Improve Newborn Resuscitation.

Joanna Haynes,Jeffrey Perlman,Hege Ersdal,Siren Rettedal

doi:10.3390/children8121115

Joanna Haynes, Jeffrey Perlman + Show 2 more

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https://doi.org/10.3390/children8121115

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Abstract

Positive pressure ventilation of the non-breathing newborn is a critical and time-sensitive intervention, considered to be the cornerstone of resuscitation. Many healthcare providers working in delivery units in high-resource settings have little opportunity to practise this skill in real life, affecting their performance when called upon to resuscitate a newborn. Low-dose, high-frequency simulation training has shown promise in low-resource settings, improving ventilation performance and changing practice in the clinical situation. We performed a randomised controlled study of low-dose, high-frequency simulation training for maintenance of ventilation competence in a multidisciplinary staff in a busy teaching hospital in Norway. We hypothesised that participants training according to a low-dose, high-frequency protocol would perform better than those training as they wished. Our results did not support this, although the majority of protocol participants were unable to achieve training targets. Subgroup analysis comparing no training to at least monthly training did identify a clear benefit to regular simulation practice. Simulated ventilation competence improved significantly for all participants over the course of the study. We conclude that frequent, short, simulation-based training can foster and maintain newborn ventilation skills in a multidisciplinary delivery unit staff in a high-resource setting.

Highlights

The need for neonatal resuscitation is ubiquitous and often unpredictable
220 healthcare personnel (HCP) were recruited to the study and performed baseline testing, T1. 191 progressed to the education session, performed post-teaching T2, and were randomised. 187 completed nine months of training and performed post-training T3 with four being lost to follow-up
T4aobfle121 shows the distribution of participants from the six professional groups

Summary

Introduction

The need for neonatal resuscitation is ubiquitous and often unpredictable. Positive pressure ventilation (PPV) of the non-breathing newborn is the cornerstone of resuscitation. Studies in both high- and low-resource settings suggest that PPV skills are often suboptimal [1,2]. Simulation training is widely used to prepare healthcare personnel (HCP) to manage this stressful and time-critical event, and is an integral part of formal neonatal resuscitation programmes [3,4]. Infrequent training (once a year or less) results in deterioration of knowledge and resuscitation skills in particular [5,6]. Simulationbased booster training may maintain skills acquired in formal training programmes [7]. Optimal training strategies remain unclear, and studies elucidating this issue are urgently required [8]

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