Video-Based Evaluation of Checklist Adherence on a Neonatal Intensive Care Unit: A Prospective Observational Study.

Area of Science:

• Medical Education
• Patient Safety
• Clinical Procedures

Background:

• Procedural performance in Neonatal Intensive Care Units (NICUs) relies on skills and preparation.
• Checklists improve adherence to guidelines, with video review further enhancing this compliance.

Purpose of the Study:

• To evaluate video recordings for assessing checklist deviations during NICU procedures.
• To determine the frequency of proceduralists deviating from checklists.
• To explore the utility of video recordings in refining and creating checklists.

Main Methods:

• Analysis of 51 videos from six procedures (intubation, chest drain insertion, UVC, CVC, lumbar puncture, Ommaya reservoir puncture) in a tertiary NICU.
• Scoring each checklist step using a 4-point scale based on video recordings.
• Involving twenty proceduralists with varying experience levels.

Main Results:

• 78% of checklist steps were assessable via video analysis.
• Deviations from checklists were identified in 10%-17.9% of all procedures.
• Two novel checklists were developed based on video analysis findings.

Conclusions:

• Checklist deviations are frequent in clinical practice and can be reliably detected using video recordings.
• Video analysis is a valuable tool for revising current and creating new procedural checklists.
• This method supports quality improvement initiatives in NICU procedural care.