Simulation to Support Standardization of Delivery Room Management of the Very Low Birth-Weight Infant

• Published in: Advances in neonatal care Vol. 21; no. 6; pp. E153 - E161
• Main Authors: Wiesbrock, Jeanne, Andresen, Pamela, Brough, Megan
• Format: Journal Article
• Language: English
• Published: United States Wolters Kluwer Health, Inc 01-12-2021; by The National Association of Neonatal Nurses
• Subjects: Delivery Rooms; Female; Humans; Infant; Infant, Newborn; Infant, Premature; Infant, Very Low Birth Weight; Pregnancy; Reference Standards; Resuscitation
• ISSN: 1536-0903; 1536-0911
• DOI: 10.1097/ANC.0000000000000768

BACKGROUND:The birth of a very low birth-weight (VLBW) infant occurs infrequently, especially in the community hospital setting. It is critical that the team managing care of the infant in its first minutes of life follow evidence-based resuscitation guidelines and practices to optimize outcomes for this population.
PURPOSE:To implement a simulation program in a community hospital setting that supports standardized evidence-based delivery room practices of the premature infant born less than 30 weeksʼ gestation.
METHODS:Two VLBW emergent delivery scenarios were developed utilizing the neonatal resuscitation program scenario template. Special care nursery interprofessional team members from a community hospital were invited to participate in the simulation program (n = 28). Participants were asked to complete a neonatal version of the Emergency Response Confidence Tool, then view a short presentation related to delivery room management of VLBW infants. Participants attended a simulation program and completed the confidence tool after simulation. The simulation facilitator and unit educator documented team actions during each simulation session.
FINDINGS/RESULTS:Fifteen opportunities for improvement within 4 simulation sessions were identified and categorized. Fourteen paired pre- and postsurveys were analyzed. Reported confidence increased in 22 of 23 resuscitation-related items.
IMPLICATIONS FOR PRACTICE:Education and simulation programs providing opportunities to experience high-risk, low-frequency VLBW delivery situations can assist in identifying areas for improvement and may improve team member confidence.
IMPLICATIONS FOR RESEARCH:Additional research is needed to assess whether results would be similar if this program were provided at all levels of neonatal care throughout the healthcare system.