Tablet-Based Decision Support Tool Improves Performance of Neonatal Resuscitation: A Randomized Trial in Simulation

Area of Science:

• Medical simulation
• Neonatal resuscitation
• Clinical decision support

Background:

• Neonatal Resuscitation Program (NRP) algorithm adherence is critical but challenging for healthcare teams.
• Existing decision support tools (DSTs) lack sufficient testing in neonatal resuscitation.
• Optimal team size for neonatal resuscitation remains undetermined.

Purpose of the Study:

• To evaluate the impact of a tablet-based DST on NRP algorithm compliance.
• To determine if team size (2 vs. 3 providers) affects NRP adherence.
• To assess the interaction between DST use and team size in simulated neonatal resuscitations.

Main Methods:

• 109 healthcare providers (HCPs) were randomized into teams of 2 or 3.
• Participants used either a tablet-based DST or memory recall during simulated neonatal resuscitation.
• NRP compliance was primary outcome, measured by the modified Neonatal Resuscitation Performance Evaluation (NRPE).

Main Results:

• DST use significantly improved overall NRPE scores compared to memory alone (p = 0.015).
• No significant difference in NRPE scores was found between 2- and 3-provider teams.
• Cumulative time error decreased with DST use, though not significantly (p = 0.057); team size did not affect time error.

Conclusions:

• DSTs enhance adherence to the NRP algorithm in simulated neonatal resuscitation.
• Team size of 2 or 3 providers demonstrated similar performance.
• Further clinical evaluation of DSTs in real-world neonatal resuscitation is recommended.