Infant Simulationa Program In-hospital Resuscitation Education - Delivery Room

描述(申请人提供)：全球范围内，每年有100多万新生儿死于窒息。1、2有效的抢救性呼吸维持生命，直到新生儿对呼吸的控制得到改善。然而，医疗服务提供者(HCP)的焦虑、操作员的位置、HCP培训、拥挤的床位空间和婴儿的大小是及时有效提供救援呼吸的重大障碍。此外，培训能力是短暂的，新生儿复苏技能在12周内出现下降。15我们的长期目标是通过实施创新的院内复苏教育捆绑婴儿模拟计划(INSPIRE-D)，提高初级HCP评估和为有出生窒息风险的新生儿提供有效救援性呼吸的速度和能力，该计划包括培训触发器、团队抱抱、“滚动复习”培训、每次复苏后立即进行的简短团队反思和定期的教育汇报干预。本研究的目的是比较捆绑的INSPIRE-D干预与标准的美国儿科学会新生儿复苏培训和教育对HCP新生儿复苏信心和技能表现(能力)的有效性。总体假设是，新的“INSPIRE-D”捆绑包的实施将改善HCP新生儿复苏信心和技能表现，以及与改善患者生存相关的护理过程。使用创新技术，我们将：1)确认复苏措施(抢救性呼吸)的发生率、基线患者数据特征、对当前指南的遵从性以及在实施INSPIRE-D捆绑实施之前的患者结果；2)比较模拟INSPIRE-D干预和标准新生儿复苏培训在HCP抢救性呼吸能力和信心方面的有效性；以及3)比较模拟INSPIRE-D干预和标准新生儿复苏培训在重要、可测量的患者预后方面的有效性。这项拟议的研究意义重大，因为它将优化提供者对新生儿窒息的护理的信心、能力以及质量和安全。在成功完成后，强劲的初步数据表明，这种培训干预将产生高影响力、持久的技能和知识，可以传播给一线临床提供者，并将产生持续而强大的影响 数以千计的新生儿，医疗保健提供者，以及复苏科学领域。

DESCRIPTION (provided by applicant): Globally, asphyxia from apnea causes over 1 million neonatal deaths each year.1,2 Effective rescue breathing sustains life until the newborn's control of breathing improves. However, healthcare provider (HCP) anxiety, operator position, HCP training, crowded bed space and infant size are significant barriers to timely and effective delivery of rescue breathing. Additionally, training competency is transient, with a decline in newborn resuscitation skills reported within 12 weeks.15 Our long term objective is to improve the speed and ability of the primary HCP to assess and provide effective rescue breathing to newborns at risk for birth asphyxia by implementing an innovative bundled Infant Simulation Program for In-hospital Resuscitation Education - in the Delivery Room (INSPIRE-D) program, consisting of a Training Trigger, Team Huddle, "Rolling Refresher" training, Brief Team Reflection immediately after every resuscitation, and periodic Educational Debriefing intervention. The objective of this research proposal is to compare the effectiveness of the bundled INSPIRE-D intervention to standard American Academy of Pediatrics neonatal resuscitation training and education on HCP newborn resuscitation confidence and skill performance (competence). The overall hypothesis is that implementation of a novel "INSPIRE-D" bundle will improve HCP newborn resuscitation confidence and skill performance, and process of care associated with improved patient survival. Using innovative techniques, we will: 1) confirm incidence of resuscitative measures (rescue breathing), and baseline patient data characteristics, compliance with current guidelines, and patient outcomes prior to INSPIRE-D bundle implementation; 2) compare the effectiveness of a simulation INSPIRE-D intervention to standard neonatal resuscitation training on HCP rescue breathing competence and confidence; and, 3) compare the effectiveness of a simulation INSPIRE-D intervention to standard neonatal resuscitation training on important, measurable patient outcomes. The proposed research is significant, because it will optimize provider confidence, competence, and quality and safety of care for newborns with birth asphyxia. On successful completion, strong preliminary data suggests that this training intervention will yield high impact, durable skills and knowledge that can be disseminated to front-line clinical providers and will exert a sustained, powerful influence on thousands of newborns, healthcare providers, and the field of resuscitation science.