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Telecoaching Improves Positive Pressure Ventilation Performance During Simulated Neonatal Resuscitations

INTRODUCTION: Positive pressure ventilation (PPV) is a critical skill for neonatal resuscitation. We hypothesized that telecoaching would improve PPV performance in neonatal providers during simulated neonatal resuscitations. SETTING: Level IV neonatal intensive care unit (NICU). METHODS: This prosp...

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Detalles Bibliográficos
Autores principales: Castera, Mark, Gray, Megan M., Gest, Carri, Motz, Patrick, Sawyer, Taylor, Umoren, Rachel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Mary Ann Liebert, Inc., publishers 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9004288/
https://www.ncbi.nlm.nih.gov/pubmed/35720453
http://dx.doi.org/10.1089/tmr.2021.0049
Descripción
Sumario:INTRODUCTION: Positive pressure ventilation (PPV) is a critical skill for neonatal resuscitation. We hypothesized that telecoaching would improve PPV performance in neonatal providers during simulated neonatal resuscitations. SETTING: Level IV neonatal intensive care unit (NICU). METHODS: This prospective crossover study included 14 experienced NICU nurses and respiratory therapists who performed PPV on a mannequin that recorded parameters of ventilation efficiency. Participants were randomized to practice independently (control) or with live feedback from a remote facilitator through audiovisual connection (intervention) and then switched to the opposite group. Participants' mask leak percentage, ventilation rates, and pressure delivery were analyzed. RESULTS: The primary outcome of mask leak percentage was significantly increased in the telecoaching group (19% [interquartile range {IQR} 14–59.25] vs. 100% [IQR 88–100] leak, p = 0.0001). The secondary outcome of peak inspiratory pressure (PIP) delivery was also increased (median 27.6 [IQR 23.5–34.7] vs. 23.3 [IQR 19.1–32.8] cmH(2)O, p < 0.001). Differences in ventilation rates were not statistically significant (55 vs. 58 breaths/min, p = 0.51). CONCLUSION: Participants demonstrated better PPV performance during telecoaching with less mask leak. The intervention group also had higher measured peak inspiratory pressures. Telecoaching may be a feasible method to provide real-time feedback to health care providers during simulated neonatal resuscitations. HYPOTHESIS: Neonatal providers who receive telecoaching during simulated resuscitations will perform PPV more effectively than those who do not receive telecoaching.