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新生儿复苏的视频记录:一项为广泛采用提供信息的可行性研究。

Video recording of neonatal resuscitation: A feasibility study to inform widespread adoption.

作者信息

Shivananda Sandesh, Twiss Jennifer, El-Gouhary Enas, El-Helou Salhab, Williams Connie, Murthy Prashanth, Suresh Gautham

机构信息

Sandesh Shivananda, Jennifer Twiss, Enas el-Gouhary, Salhab el-Helou, Connie Williams, Prashanth Murthy, Department of Pediatrics, McMaster University, Hamilton, ON L8N 3Z5, Canada.

出版信息

World J Clin Pediatr. 2017 Feb 8;6(1):69-80. doi: 10.5409/wjcp.v6.i1.69.

Abstract

AIM

To determine the feasibility of introducing video recording (VR) of neonatal resuscitation (NR) in a perinatal centre.

METHODS

This was a prospective cohort quality improvement study on preterm infants and their caregivers. Based on evidence and experience of other centers using VR intervention, a contextually relevant implementation and evaluation strategy was designed in the planning phase. The components of intervention were pre-resuscitation team huddle, VR of NR and video debriefing (VD), all occurring on the same day. Various domains of feasibility and sustainability as well as feasibility criteria were predefined. Data for analysis was collected using quantitative and qualitative methods.

RESULTS

Seventy-one caregivers participated in VD of 14 NRs facilitated by six trained instructors. Ninety-one percent of caregivers perceived enhanced learning and patient safety and, 48 issues were identified related to policy, caregiver roles, and latent safety threats. Ninety percent of caregivers expressed their willingness to participate in VD activity and supported the idea of integrating it into a resuscitation team routine. Eighty-three percent and 50% of instructors expressed satisfaction with video review software and quality of audio VR. No issues about maintenance of infant or caregivers' confidentiality and erasure of videos were reported. Criteria for feasibility were met (refusal rate of < 10%, VR performed on > 50% of occasions, and < 20% caregivers' perceiving a negative impact on team performance). Necessary adaptations to enhance sustainability were identified.

CONCLUSION

VR of NR as a standard of care quality assurance activity to enhance caregivers' learning and create opportunities that improve patient safety is feasible. Despite its complexity with inherent challenges in implementation, the intervention was acceptable, implementable, and potentially sustainable with adaptations.

摘要

目的

确定在围产期中心引入新生儿复苏(NR)视频记录(VR)的可行性。

方法

这是一项针对早产儿及其护理人员的前瞻性队列质量改进研究。基于其他使用VR干预的中心的证据和经验,在规划阶段设计了一个与实际情况相关的实施和评估策略。干预的组成部分包括复苏前团队会议、NR的VR和视频汇报(VD),所有这些都在同一天进行。预先定义了可行性和可持续性的各个领域以及可行性标准。使用定量和定性方法收集分析数据。

结果

71名护理人员参与了由6名训练有素的教员协助的14次NR的VD。91%的护理人员认为学习和患者安全得到了加强,并且确定了48个与政策、护理人员角色和潜在安全威胁相关的问题。90%的护理人员表示愿意参与VD活动,并支持将其纳入复苏团队常规工作的想法。83%和50%的教员对视频审查软件和音频VR的质量表示满意。未报告有关婴儿或护理人员保密维护以及视频删除的问题。满足了可行性标准(拒绝率<10%,在>50%的情况下进行VR,并且<20%的护理人员认为对团队绩效有负面影响)。确定了为提高可持续性而进行必要调整的方法。

结论

将NR的VR作为一种护理质量保证活动标准,以加强护理人员的学习并创造改善患者安全的机会是可行的。尽管其实施过程复杂且存在固有挑战,但该干预措施是可接受的、可实施的,并且经过调整后可能具有可持续性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9678/5296632/892f1f190526/WJCP-6-69-g001.jpg

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