Evaluation of the effectiveness of the standardized neonatal resuscitation program.
Evaluation of the effectiveness of the standardized neonatal resuscitation program.
复制标题
DOI：
10.1038/sj.jp.7210551
复制
发表时间：
2001-09-01
期刊：
影响因子：
--
通讯作者：
Yee, Y J
中科院分区：
文献类型：
--
作者：
Singhal, N;McMillan, D D;Yee, Y J
目的：确定接受过新生儿复苏计划（NRP）培训的医护人员在新生儿复苏中是否使用了NRP指南。确定医疗记录中自我报告与复苏记录之间的差异。研究设计：使用一份有效的问卷，参与新生儿复苏的个人自愿打电话并在交互式语音应答（IVR）系统上回答问题。这项研究是在阿尔伯塔省南部每年接生7500人的二级医院进行的。结果：研究期间出生的5155名婴儿中，有16%需要复苏（袋罩通气10.6%，胎就插管或间歇正压通气，IPPV, 3.6%，心脏按摩，CM, 0.3%，肾上腺素0.1%，纳洛酮6.9%）。在可以评估干预措施的婴儿中，袋和面罩的正确率为99%，IPPV气管插管的正确率为100%，CM的正确率为100%。只有75%的婴儿正确处理了胎便，92%的婴儿按照指南使用了纳洛酮。有更多的情况下，IVR（48）报告了一个过程，这不是图表，而不是图表，IVR（21）没有报告。IVR识别的教育需求包括复苏技能和NRP管理指征。结论：气囊和面罩通气和插管在新生儿复苏中的应用比以往报道的更为普遍。粪污婴儿的处理和纳洛酮的使用需要进一步的教育。与图表相比，使用IVR系统可以更完整地记录干预措施的基本原理和确定继续教育需求。
OBJECTIVE: To determine if health care personnel trained in the Neonatal Resuscitation Program (NRP) used the NRP guidelines in the resuscitation of newborn babies. To determine differences between self-reporting and documentation of resuscitation in medical records.STUDY DESIGN: Using a validated questionnaire, individuals participating in resuscitation of newborns voluntarily phoned and answered questions on an Interactive Voice Response (IVR) system. The study was undertaken in level II hospitals in Southern Alberta with 7500 deliveries per year.RESULTS: Of the 5155 babies delivered during the study, 16% required resuscitation (bag and mask ventilation 10.6%, intubation for meconium or intermittent positive pressure ventilation, IPPV, 3.6%, cardiac massage, CM, 0.3%, epinephrine 0.1%, naloxone 6.9%). Of babies whose interventions could be assessed, bag and mask was correct in 99%, endotracheal intubation for IPPV in 100%, and CM in 100%. Only 75% of babies had meconium managed correctly and 92% had naloxone administered according to guidelines. There were more instances where IVR (48) reported a procedure, which was not charted versus charted and not reported by IVR (21). Educational needs identified by IVR included skills of resuscitation and NRP indications for management.CONCLUSION: Bag and mask ventilation and intubation for neonatal resuscitation are more common than previously reported. Management of the meconium-stained baby and use of naloxone require further education. Compared to charts, use of IVR system allows more complete documentation with rationale of interventions and identification of continuing educational needs.