Bayoumi Mohammad A A, Elmalik Einas E, Ali Hossamaldein, D'Souza Sunitha, Furigay Jojo, Romo Ava, Shyam Sunitha, Singh Rajvir, Koobar Olfa, Al Shouli Jihad, van Rens Matheus, Abounahia Fouad F, Gad Ashraf, Elbaba Mostafa, Lutfi Samawal
Neonatal Intensive Care Unit (NICU), Women's Wellness and Research Center (WWRC), Hamad Medical Corporation (HMC), Doha, Qatar.
Pediatric Department, Hamad General Hospital (HGH), Hamad Medical Corporation (HMC), Doha, Qatar.
Front Pediatr. 2022 Mar 21;10:843147. doi: 10.3389/fped.2022.843147. eCollection 2022.
We describe the process of implementation, adaptation, expansion and some related clinical intuitional impacts of the neonatal simulation program since its launch in 2016 in a non-simulation neonatal unit. The team has developed 6 types of curricula: 1 full-day course and 5 half-day workshops. A total of 35 free of charge simulation courses/workshops were conducted, 32 in Qatar and 3 abroad with a total of 799 diverse participants. There was a steady increase in the overall success rate of PICC insertion from 81.7% (309/378) to 97.6% (439/450) across 3 years ( < 0.0001). The first attempt PICC insertion success rate has been also increased from 57.7% (218/378) to 66.9% (301/450) across 3 years. The mean duration of PICC insertion has been improved from 39.7 ± 25 to 34.9 ± 12.4 min after implementing the program ( = 0.33). The mean duration of the LISA catheter insertion at the beginning of the workshop was 23.5 ± 15.9 compared to 12.1 ± 8.5 s at the end of the workshop ( = 0.001). When it came to clinical practise in real patients by the same participants, the overall LISA catheter insertion success rate was 100% and the first attempt success rate was 80.4%. The mean duration of LISA catheter insertion in real patients was 26.9 ± 13.9 s compared to the end of the workshop ( = 0.001). The mean duration of the endotracheal intubation at the beginning of the workshop was 12.5 ± 9.2 compared to 4.2 ± 3.8 s at the end of the workshop ( = 0.001). In real patients, the first-attempt intubation success rate has been improved from 37/139 (26.6%) in the first year to 141/187 (75.5%) in the second year after the program implementation ( = 0.001). The mean duration of successful endotracheal intubation attempts has been improved from 39.1 ± 52.4 to 20.1 ± 9.9 s ( = 0.78). As per the participants, the skills learned in the program sessions help in protecting neonates from potential harm and improve the overall neonatal outcome. Implementing a neonatal simulation program is a promising and feasible idea. Our experience can be generalised and replicated in other neonatal care institutions.
我们描述了自2016年在一个非模拟新生儿病房启动新生儿模拟项目以来的实施、调整、扩展过程以及一些相关的临床直观影响。该团队开发了6种课程类型:1门全天课程和5门半天工作坊。共举办了35次免费模拟课程/工作坊,其中32次在卡塔尔,3次在国外,共有799名不同参与者。3年期间,经外周静脉穿刺中心静脉置管(PICC)的总体成功率从81.7%(309/378)稳步提高到97.6%(439/450)(<0.0001)。3年期间,PICC首次穿刺成功率也从57.7%(218/378)提高到66.9%(301/450)。实施该项目后,PICC置管的平均时长从39.7±25分钟改善至34.9±12.4分钟(P=0.33)。工作坊开始时,喉罩气道导管(LISA)置入的平均时长为23.5±15.9秒,而工作坊结束时为12.1±8.5秒(P=0.001)。当相同参与者在真实患者身上进行临床实践时,LISA导管置入的总体成功率为100%,首次尝试成功率为80.4%。与工作坊结束时相比,在真实患者中LISA导管置入的平均时长为26.9±13.9秒(P=0.001)。工作坊开始时气管插管的平均时长为12.5±9.2秒,而工作坊结束时为4.2±3.8秒(P=0.001)。在真实患者中,项目实施后的第一年首次插管成功率为37/139(26.6%),第二年提高到141/187(75.5%)(P=0.001)。成功气管插管尝试的平均时长从39.1±52.4秒改善至20.1±9.9秒(P=0.78)。据参与者表示,在项目课程中学到的技能有助于保护新生儿免受潜在伤害,并改善整体新生儿结局。实施新生儿模拟项目是一个有前景且可行的想法。我们的经验可以在其他新生儿护理机构中推广和复制。