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Advancing Neonatal Tele-Resuscitation in Community Settings: Effects of Targeted Workshops on Provider Perception and
Tavleen Sandhu1,2, Lise DeShea3, Jennifer L Fang4
1Department of Pediatrics, Division of Neonatal Medicine, The University of Texas Southwestern Medical Center/Children's Medical Center, Dallas, Texas, USA.
Background:
Approximately 50,000 neonates weighing under 1,500 grams are born annually in the United States, with 15-20% delivered in smaller community hospitals without a neonatal intensive care unit. These "outborn" infants face higher risks of adverse outcomes due to limited resources. Implementing tele-resuscitation services with targeted training workshops may enhance providers' technical skills, confidence, and perceptions of feasibility and acceptability.
Methods:
In January 2023, Oklahoma Children's Hospital launched a tele-resuscitation program offering real-time, audio-video support to community hospital staff. This service targeted neonates ≤32 weeks' gestation, <1,500 g, and those >32 weeks requiring advanced resuscitation. Workshops were hosted to give community hospital providers a first hand experience with the technology, and it included background on tele-resuscitation, technical skills training, and neonatal resuscitation simulations incorporating telemedicine. Pre- and postworkshop surveys with Likert scale questions assessed attendees' confidence in advanced resuscitation and feasibility of integrating tele-resuscitation into practice.
Results:
Briefly, 20 community providers attended two interprofessional workshops, including 5 physicians (25%), 11 nurses (55%), and 4 respiratory therapists (20%). One-quarter of attendees reported prior experience with telemedicine, and one attendee reported prior experience with tele-resuscitation. Following the workshops, participant confidence in performing tasks such as intubation, umbilical line placement, needle thoracentesis, and debriefing increased significantly (p < 0.001 for all procedures). While ratings for the appeal and applicability of telemedicine to their practice showed no significant changes (p = 0.267 and p = 0.056, respectively), the perceived feasibility of tele-resuscitation significantly improved after the workshop (p = 0.029).
Conclusions:
Neonatal tele-resuscitation workshops improved providers' perceptions of this service and increased their acceptance of such a program. Additionally, the skill sessions and simulated resuscitations increased their confidence with procedures commonly performed during advanced neonatal resuscitation.
