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Start a Neonatal Extracorporeal Membrane Oxygenation Program: A Multistep Team Training

Background: Extracorporeal membrane oxygenation (ECMO) is a complex life-saving support for acute cardio-respiratory failure, unresponsive to medical treatment. Emergency events on ECMO are rare but require immediate and proficient management. Multidisciplinary ECMO team members need to acquire and...

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Autores principales: Raffaeli, Genny, Ghirardello, Stefano, Vanzati, Mara, Baracetti, Chiara, Canesi, Francesco, Conigliaro, Federica, Gentilino, Valerio, Macchini, Francesco, Fumagalli, Monica, Ciralli, Fabrizio, Pesenti, Nicola, Passera, Sofia, Neri, Simona, Franzini, Stefania, Leva, Ernesto, Plevani, Laura, Mosca, Fabio, Cavallaro, Giacomo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5986935/
https://www.ncbi.nlm.nih.gov/pubmed/29896465
http://dx.doi.org/10.3389/fped.2018.00151
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author Raffaeli, Genny
Ghirardello, Stefano
Vanzati, Mara
Baracetti, Chiara
Canesi, Francesco
Conigliaro, Federica
Gentilino, Valerio
Macchini, Francesco
Fumagalli, Monica
Ciralli, Fabrizio
Pesenti, Nicola
Passera, Sofia
Neri, Simona
Franzini, Stefania
Leva, Ernesto
Plevani, Laura
Mosca, Fabio
Cavallaro, Giacomo
author_facet Raffaeli, Genny
Ghirardello, Stefano
Vanzati, Mara
Baracetti, Chiara
Canesi, Francesco
Conigliaro, Federica
Gentilino, Valerio
Macchini, Francesco
Fumagalli, Monica
Ciralli, Fabrizio
Pesenti, Nicola
Passera, Sofia
Neri, Simona
Franzini, Stefania
Leva, Ernesto
Plevani, Laura
Mosca, Fabio
Cavallaro, Giacomo
author_sort Raffaeli, Genny
collection PubMed
description Background: Extracorporeal membrane oxygenation (ECMO) is a complex life-saving support for acute cardio-respiratory failure, unresponsive to medical treatment. Emergency events on ECMO are rare but require immediate and proficient management. Multidisciplinary ECMO team members need to acquire and maintain over time cognitive, technical and behavioral skills, to safely face life-threatening clinical scenarios. Methods: A multistep educational program was delivered in a 4-year period to 32 ECMO team members, based on guidelines from the Extracorporeal Life Support Organization. A first traditional module was provided through didactic lectures, hands-on water drills, and laboratory animal training. The second phase consisted of a multi-edition high-fidelity simulation-based training on a modified neonatal mannequin (SimNewB®). In each session, participants were called to face, in small groups, ten critical scenarios, followed by debriefing time. Trainees underwent a pre-test for baseline competency assessment. Once completed the full training program, a post-test was administered. Pre- and post-test scores were compared. Trainees rated the educational program through survey questionnaires. Results: 28 trainees (87.5%) completed the full educational program. ECMO staff skills improved from a median pre-test score of 7.5/18 (IQR = 6–11) to 14/18 (IQR = 14–16) at post-test (P < 0.001, Wilcoxon rank test). All trainees highly rated the educational program and its impact on their practice. They reported high-fidelity simulations to be beneficial to novice learners as it increased self-confidence in ECMO-emergencies (according to 100% of surveyed), theoretical knowledge (61.5%) and team-work/communicative skills (58%). Conclusions: The multistep ECMO team training increased staff' knowledge, technical skills, teamwork, and self-confidence, allowing the successful development of a neonatal respiratory ECMO program. Conventional training was perceived as relevant in the early phase of the program development, while the active learning emerged to be more beneficial to master ECMO knowledge, specific skills, and team performance.
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spelling pubmed-59869352018-06-12 Start a Neonatal Extracorporeal Membrane Oxygenation Program: A Multistep Team Training Raffaeli, Genny Ghirardello, Stefano Vanzati, Mara Baracetti, Chiara Canesi, Francesco Conigliaro, Federica Gentilino, Valerio Macchini, Francesco Fumagalli, Monica Ciralli, Fabrizio Pesenti, Nicola Passera, Sofia Neri, Simona Franzini, Stefania Leva, Ernesto Plevani, Laura Mosca, Fabio Cavallaro, Giacomo Front Pediatr Pediatrics Background: Extracorporeal membrane oxygenation (ECMO) is a complex life-saving support for acute cardio-respiratory failure, unresponsive to medical treatment. Emergency events on ECMO are rare but require immediate and proficient management. Multidisciplinary ECMO team members need to acquire and maintain over time cognitive, technical and behavioral skills, to safely face life-threatening clinical scenarios. Methods: A multistep educational program was delivered in a 4-year period to 32 ECMO team members, based on guidelines from the Extracorporeal Life Support Organization. A first traditional module was provided through didactic lectures, hands-on water drills, and laboratory animal training. The second phase consisted of a multi-edition high-fidelity simulation-based training on a modified neonatal mannequin (SimNewB®). In each session, participants were called to face, in small groups, ten critical scenarios, followed by debriefing time. Trainees underwent a pre-test for baseline competency assessment. Once completed the full training program, a post-test was administered. Pre- and post-test scores were compared. Trainees rated the educational program through survey questionnaires. Results: 28 trainees (87.5%) completed the full educational program. ECMO staff skills improved from a median pre-test score of 7.5/18 (IQR = 6–11) to 14/18 (IQR = 14–16) at post-test (P < 0.001, Wilcoxon rank test). All trainees highly rated the educational program and its impact on their practice. They reported high-fidelity simulations to be beneficial to novice learners as it increased self-confidence in ECMO-emergencies (according to 100% of surveyed), theoretical knowledge (61.5%) and team-work/communicative skills (58%). Conclusions: The multistep ECMO team training increased staff' knowledge, technical skills, teamwork, and self-confidence, allowing the successful development of a neonatal respiratory ECMO program. Conventional training was perceived as relevant in the early phase of the program development, while the active learning emerged to be more beneficial to master ECMO knowledge, specific skills, and team performance. Frontiers Media S.A. 2018-05-29 /pmc/articles/PMC5986935/ /pubmed/29896465 http://dx.doi.org/10.3389/fped.2018.00151 Text en Copyright © 2018 Raffaeli, Ghirardello, Vanzati, Baracetti, Canesi, Conigliaro, Gentilino, Macchini, Fumagalli, Ciralli, Pesenti, Passera, Neri, Franzini, Leva, Plevani, Mosca and Cavallaro. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Raffaeli, Genny
Ghirardello, Stefano
Vanzati, Mara
Baracetti, Chiara
Canesi, Francesco
Conigliaro, Federica
Gentilino, Valerio
Macchini, Francesco
Fumagalli, Monica
Ciralli, Fabrizio
Pesenti, Nicola
Passera, Sofia
Neri, Simona
Franzini, Stefania
Leva, Ernesto
Plevani, Laura
Mosca, Fabio
Cavallaro, Giacomo
Start a Neonatal Extracorporeal Membrane Oxygenation Program: A Multistep Team Training
title Start a Neonatal Extracorporeal Membrane Oxygenation Program: A Multistep Team Training
title_full Start a Neonatal Extracorporeal Membrane Oxygenation Program: A Multistep Team Training
title_fullStr Start a Neonatal Extracorporeal Membrane Oxygenation Program: A Multistep Team Training
title_full_unstemmed Start a Neonatal Extracorporeal Membrane Oxygenation Program: A Multistep Team Training
title_short Start a Neonatal Extracorporeal Membrane Oxygenation Program: A Multistep Team Training
title_sort start a neonatal extracorporeal membrane oxygenation program: a multistep team training
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5986935/
https://www.ncbi.nlm.nih.gov/pubmed/29896465
http://dx.doi.org/10.3389/fped.2018.00151
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