P3.Q340: Equipping healthcare professionals at emergency departments with NRP training to increase confidence and improve neonatal outcomes​

Purpose/Objectives: Neonatal resuscitation in the emergency department setting is a low-frequency, high-risk event and requires providers to think and act quickly to address respiratory distress, metabolic acidosis, hypoglycemia, and potential death in the newborn. The healthcare team must have a working knowledge of specialized equipment and technical skills necessary for neonatal resuscitation. In a large healthcare system, it was identified that there was a gap in Neonatal Resuscitation Program (NRP) training for emergency departments without obstetric and neonatal intensive care support. A gap in this knowledge risks injury or death to the newborn.

Design/Methods: Classes for this project are in situ utilizing site-specific infant warmers and resuscitation equipment; emergency department specific NRP scenarios were created for contextual learning. The NRP algorithm is systematically reviewed, learning gaps are identified, and content is reviewed until mastery is complete. Scenarios are repeated as needed with focused attention on improving performance until scenario objectives are met.  Participants are given immediate feedback on their performance and are encouraged to ask questions in a low-risk environment (Cheng et al., 2020). This project also provides checklists and cognitive aids with important NRP steps and decision tools to optimize care without increasing cognitive load (Huynh et al, 2021). In addition to NRP training, an online newsletter with embedded videos, quizzes, and research is developed and distributed quarterly to emergency department teammates to review aspects of the NRP learning.

Results: Pre- and post-survey data was collected from 245 NRP training participants to give insight into the confidence levels of neonatal resuscitation skills before and after training based on a survey by Huynh et al. (2021). Pre-survey data suggests that participants were somewhat uncomfortable with neonatal resuscitation before the training with an average score of 2.07 out of 4.  Post-survey data showed an average score of 3.33 out of 4 suggesting an increase in participant confidence in neonatal resuscitation after training.  The post-survey also revealed that participants desired additional off-cycle NRP training due to the high-risk, low-frequency occurrence of neonatal resuscitation, with 44% of participants requesting yearly NRP training.

Conclusion/Discussion: Given that neonatal resuscitation is a high-risk, low-frequency event, the goal is to grow provider confidence through greater access to NRP skills training and practice. Literature recognizes that resuscitation training improves confidence and willingness to respond to a resuscitative emergency (Angute et al., 2023) and that confidence positively correlates with improved resuscitation performance (Jaskiewicz et al., 2022). Newsletter interaction and quiz results are monitored by the project team; this data will guide future NRP scenario development and newsletter offerings, aiming to continue to increase confidence between NRP training.