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Low-Tech In-Situ Simulation Improves Neonatal Resuscitation Skills in Community Hospitals.

Melanie D Stempowski1, Michael Chaka1, Julia Liebner1

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Summary
This summary is machine-generated.

A low-cost simulation project improved neonatal resuscitation performance in community hospitals. This initiative enhanced clinician confidence and reduced safety threats, fostering a culture of simulation-based education.

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Area of Science:

  • Medical Simulation
  • Quality Improvement
  • Neonatal Resuscitation

Background:

  • Community hospitals manage 40% of US births but face neonatal resuscitation challenges due to infrequent exposure.
  • High-acuity resuscitations highlighted a need for improved neonatal resuscitation training in these settings.
  • Existing Neonatal Resuscitation Program (NRP) training augmentation via simulation is resource-intensive for many community hospitals.

Purpose of the Study:

  • To develop an affordable and sustainable simulation project using quality improvement (QI) principles.
  • To enhance neonatal resuscitation performance in community hospital labor and delivery units.
  • To address resource limitations hindering simulation-based training.

Main Methods:

  • Conducted monthly in-situ simulation sessions at 4 community sites using low-technology mannequins and high-acuity scenarios.
  • Tracked Neonatal Resuscitation Program (NRP) performance longitudinally, refining simulation, educating on performance gaps, and remediating latent safety threats (LSTs).
  • Analyzed performance scores using statistical process control and comparative statistics for NRP subsets, self-efficacy, and satisfaction.

Main Results:

  • Achieved 65 sessions over 24 months with high clinician and respiratory therapist/nurse participation.
  • Demonstrated significant improvement in NRP performance scores: clinical scores increased from 51% to 66%, and behavioral scores from 46% to 67%.
  • Reported increased participant self-efficacy (except in medication/blood administration) and high simulation satisfaction (≥4/5). Identified and mitigated 147 LSTs.

Conclusions:

  • A low-cost, sustainable simulation project effectively improved Neonatal Resuscitation Program (NRP) performance and clinician self-efficacy.
  • The model demonstrated potential for widespread implementation to foster simulation-based education and reduce LSTs in community hospitals.
  • Ongoing monthly sessions indicate the sustainability and positive impact of the simulation project beyond its initial completion.