A recorder/time coach decreases time errors during neonatal resuscitation: A randomized, simulation-based clinical...

Area of Science:

• Neonatal Medicine
• Medical Simulation
• Healthcare Quality Improvement

Background:

• Neonatal Resuscitation Program (NRP) guidelines aim to standardize care during critical events.
• Optimizing team performance and adherence to algorithms are crucial for improving neonatal resuscitation outcomes.
• Assessing the impact of additional roles on team dynamics and efficiency is essential for refining resuscitation protocols.

Purpose of the Study:

• To evaluate the impact of a hands-off recorder/time coach versus an additional hands-on provider on NRP algorithm compliance.
• To assess the effects of these interventions on team member workload during neonatal resuscitations.

Main Methods:

• A 2x2 factorial design was employed, testing an additional hands-on member and a recorder/time coach.
• The recorder/time coach provided real-time prompts and documented interventions.
• Key outcomes included cumulative time error, time to epinephrine, overall team performance (NRPE score), and workload (NASA TLX).

Main Results:

• Teams with a recorder/time coach demonstrated significantly lower cumulative time error (p < 0.001).
• An additional hands-on team member did not affect cumulative time error, epinephrine timing, or NRPE scores.
• A recorder/time coach increased team leader workload (NASA TLX overall score, p = 0.047), while an additional provider did not.

Conclusions:

• A designated, hands-off recorder/time coach enhances compliance in simulated neonatal resuscitations by reducing critical time errors.
• The addition of a recorder/time coach is a valuable strategy for improving adherence to NRP algorithms.
• Further research may explore optimal team composition and the balance between support and workload in neonatal resuscitation.