From the Section of Neonatology, Department of Pediatrics (C.M.R., K.E.P., J.L.H., N.C.S.), Baylor College of Medicine & Texas Children's Hospital, Houston, TX; and Center for Medical Simulation and Innovative Education (J.L.A.), Johns Hopkins All Children's Hospital, St. Petersburg, FL.
Simul Healthc. 2020 Aug;15(4):243-250. doi: 10.1097/SIH.0000000000000422.
Decision support tools (DST) may aid compliance of teams with the Neonatal Resuscitation Program (NRP) algorithm but have not been adequately tested in this population. Furthermore, the optimal team size for neonatal resuscitation is not known. Our aim was to determine whether use of a tablet-based DST or team size altered adherence to the NRP algorithm in teams of healthcare providers (HCPs) performing simulated neonatal resuscitation.
One hundred nine HCPs were randomized into a team of 2 or 3 and into using a DST or memory alone while performing 2 simulation scenarios. The primary outcome was NRP compliance, assessed by the modified Neonatal Resuscitation Performance Evaluation (NRPE). Secondary outcomes were the subcomponents of the NRPE score, cumulative time error (the cumulative time in seconds to perform resuscitation tasks in error, early or late, from NRP guidelines), and the interaction between DST and team size.
Decision support tool use improved total NRPE score when compared with memory alone (p = 0.015). There was no difference in NRPE score within teams of 2 compared with 3 HCPs. Cumulative time error was decreased with DST use compared with memory alone but was not significant (p = 0.057). Team size did not affect time error.
Teams with the DST had improved NRP adherence compared with teams relying on memory alone in 1 of 2 scenarios. Two and 3 HCP teams performed similarly. Given the positive results observed in the simulated environment, further testing the DST in the clinical environment is warranted.
决策支持工具（DST）可能有助于团队遵守新生儿复苏计划（NRP）算法，但尚未在该人群中进行充分测试。此外，新生儿复苏的最佳团队规模尚不清楚。我们的目的是确定在执行模拟新生儿复苏的医疗保健提供者（HCP）团队中，使用基于平板电脑的 DST 或团队规模是否会改变对 NRP 算法的遵守情况。
109 名 HCP 被随机分为 2 人或 3 人一组，并在使用 DST 或单独记忆的情况下执行 2 个模拟场景。主要结果是通过修改后的新生儿复苏绩效评估（NRPE）评估 NRP 依从性。次要结果是 NRPE 评分的子成分、累积时间误差（从 NRP 指南中错误地、过早或过晚执行复苏任务的累积秒数），以及 DST 和团队规模之间的相互作用。
与单独使用记忆相比，使用决策支持工具可提高总 NRPE 评分（p = 0.015）。在由 2 名 HCP 组成的团队中，NRPE 评分与由 3 名 HCP 组成的团队没有差异。与单独使用记忆相比，使用 DST 可减少累积时间误差，但无统计学意义（p = 0.057）。团队规模不会影响时间误差。
与仅依靠记忆的团队相比，在 2 个场景中的 1 个场景中，使用 DST 的团队对 NRP 的依从性有所提高。2 名和 3 名 HCP 团队的表现相似。鉴于在模拟环境中观察到的积极结果，有必要在临床环境中进一步测试 DST。
