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The inaccuracy of Apgar scoring
1Upstate Medical Center, Department of Pediatrics, State University of New York, Syracuse.
Summary
Healthcare professionals often miscalculate the Apgar score, a critical newborn assessment. This inaccuracy, especially among nurses, limits its value in comparing infant health outcomes.
Area of Science:
- Neonatal care
- Pediatric assessment
Background:
- The Apgar score is a standard tool for evaluating newborn health immediately after birth.
- Accurate Apgar scoring is crucial for timely clinical decisions and comparative analysis of neonatal outcomes.
Purpose of the Study:
- To assess the accuracy of Apgar score assignment by various healthcare professionals.
- To identify potential disparities in scoring accuracy among different medical roles and settings.
Main Methods:
- A quiz featuring eight descriptive neonatal cases was developed.
- 223 healthcare professionals, including pediatricians, pediatric housestaff, and nurses, completed the Apgar scoring quiz.
Main Results:
- Pediatricians and pediatric housestaff achieved the highest accuracy, correctly scoring only 68% of the time.
- Nurses from community hospitals demonstrated lower accuracy, with correct scores in only 24% of cases.
- Significant variations in scoring accuracy were observed across different professional groups.
Conclusions:
- Current Apgar scoring accuracy among healthcare professionals is suboptimal.
- Improper Apgar score assignment hinders its utility for comparing neonates within and between healthcare facilities.
- Further education and standardized training may be necessary to improve Apgar scoring reliability.