Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-28T00:58:00.343Z Has data issue: false hasContentIssue false

Preparedness of urban, general emergency department staff for neonatal resuscitation in a Canadian setting

Published online by Cambridge University Press:  04 March 2015

Nicole Kester-Greene*
Affiliation:
Department of Emergency Services, Sunnybrook Health Sciences Centre, Toronto, ON
Jacques S. Lee
Affiliation:
Department of Emergency Services, Sunnybrook Health Sciences Centre, Toronto, ON
*
Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Nicole. Nicole.kester@me.com

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Objectives:

The level of expertise and degree of training in neonatal resuscitation (NNR) of emergency physicians is not standardized and has not been measured. We sought to determine the self-reported comfort with, knowledge of, and experience with NNR of emergency department (ED) staff in a general ED prior to the opening of a new neonatal intensive care unit (NICU) and to explore factors associated with NNR comfort.

Methods:

Using Dillman methodology, we electronically surveyed full-time emergency physicians and nurses. Participants rated knowledge, comfort, and experience on 5-point Likert scales. We used logistic regression to explore factors associated with NNR comfort.

Results:

The response rate was 67.3% (n = 107). Only 4.2% of staff reported ever participating in a NNR, and only 38.7% reported any previous NNR training. Between 75 and 85% of participants rated their comfort level in caring for neonates, sense of preparedness, and knowledge of managing a sick neonate as poor or very poor. A recent neonatal clinical encounter was the strongest predictor of perceived comfort in NNR (OR = 22.2, 95% CI 5.0-98.7), as was completion of the Neonatal Resuscitation Provider (NRP) course (OR = 3.1, 95% CI 1.4-7.0).

Conclusions:

Perceived comfort with, knowledge of, and preparedness for NNR were poor in an urban, general ED prior to the opening of an NICU. Recent neonatal clinical encounter and participation in the NRP course were the strongest predictors of improved NNR comfort. In future work, we intend to assess the impact of simulation-based training on comfort with NNR among ED staff who primarily treat adults.

Type
Education • Enseignement
Copyright
Copyright © Canadian Association of Emergency Physicians 2014

References

REFERENCES

1. Canadian Institute for Health Information. Newborns born in hospital. Discharge Abstract Database/Hospital Mortality Database. Ottawa: Canadian Institute for Health Information; 2012.Google Scholar
2. Allegro, D, Young, M. Program helps in early identification and treatment of neonatal hyperbilirubinemia. Can Nurse 2009;105:67.Google Scholar
3. Anonymous. Canadian Paediatric Triage and Acuity Scale: implementation guidelines for emergency departments. CJEM 2001;3:12.Google Scholar
4. Sunnybrook Health Sciences Centre welcomes the Women and Babies program. Toronto: Canada Newswire; 2010.Google Scholar
5. Canadian Institute for Health Information. Child Health Network Emergency Task Force: emergency departments and children in Ontario. In: CIHI analysis in brief. Ottawa: Canadian Institute for Health Information; 2008.Google Scholar
6. Dillman, DA. Why choice of survey mode makes a difference. Public Health Rep 2006;121:11–3.Google Scholar
7. Dillman, D. The Tailored Design Method. 2nd ed. Hoboken (NJ): John Wiley & Sons; 2007.Google Scholar
8. Likert, R. A technique for the measurement of attitudes. Arch Psychol 1932;140:155.Google Scholar
9. Clopper, C, Pearson, E. The use of confidence or fiducial limits illustrated in the case of the binomial. Biometrika 1934;26:404–13, doi:10.1093/biomet/26.4.404.Google Scholar
10. Perlman, JM, Wyllie, J, Kattwinkel, J, et al. Part 11: Neonatal resuscitation: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Circulation 2010;122(16 Suppl 2):S516-38, doi:10.1161/CIRCULATIONAHA.110.971127.Google Scholar
11. Royal College of Physicians and Surgeons of Canada. Maintenance of Certification Program. Ottawa: Royal College of Physicians and Surgeons of Canada; 2010.Google Scholar
12. Jukkala, AM, Henly, SJ. Provider readiness for neonatal resuscitation in rural hospitals. J Obstet Gynecol Neonatal Nurs 2009;38:443–52, doi:10.1111/j.1552-6909.2009.01037.x.Google Scholar
13. Brydges, R, Carnahan, H, Rose, D, Dubrowski, A. Comparing self-guided learning and educator-guided learning formats for simulation-based clinical training. J Adv Nurs 2010;66:1832–44, doi:10.1111/j.1365-2648.2010.05338.x.CrossRefGoogle ScholarPubMed
14. Aziz, K. Neonatal Resuscitation Program. Canadian Paediatric Society; 2011.Google Scholar
15. van Amerongen, R, Klig, S, Cunningham, F Jr, et al. Pediatric advanced life support training of pediatricians in New Jersey: cause for concern? Pediatr Emerg Care 2000;16:13–7, doi:10.1097/00006565-200002000-00004.Google Scholar
16. Cichon, ME, Fuchs, S, Lyons, E, Leonard, D. A statewide model program to improve emergency department readiness for pediatric care. Ann Emerg Med 2009;54:198204, doi:10.1016/j.annemergmed.2008.12.030.Google Scholar
17. Campbell, DM, Barozzino, T, Farrugia, M, et al. High-fidelity simulaton in neonatal resuscitation. J Paediatr Cgild Health 2009;14:1923.Google Scholar
18. Langhan, TS, Rigby, IJ, Walker, IW, et al. Simulation-based training in critical resuscitation procedures improves residents competence. CJEM 2009;11:535–9.Google Scholar
19. Lee, MO, Brown, LL, Bender, J, et al. A medical simulationbased educational intervention for emergency medicine residents in neonatal resuscitation. Acad Emerg Med 2012;19:577–85, doi:10.1111/j.1553-2712.2012.01361.x.Google Scholar
20. Allan, CK, Thiagarajan, RR, Beke, D, et al. Simulation-based training delivered directly to the pediatric cardiac intensive care unit engenders preparedness, comfort, and decreased anxiety among multidisciplinary resuscitation teams. J Thorac Cardiovasc Surg 2010;140:646–52, doi:10.1016/j.jtcvs.2010.04.027.Google Scholar
21. Rosen, MA, Hunt, EA, Pronovost, PJ, et al. In situ simulation in continuing education for health care professionals: a systematic review. J Contin Educ Health Prof 2012;32:243–54, doi:10.1002/chp.21152.Google Scholar
22. Rudolph, JW, Simon, R, Raemer, D, Eppich, W. Debriefing as formative assessment: closing performance gaps in medical education. Acad Emerg Med 2008;15:1010–6, doi:10.1111/j.1553-2712.2008.00248.x.Google Scholar