Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA.
Department of Pediatrics, Royal Alexandra Hospital, Edmonton, Alberta, Canada.
BMJ Open. 2023 Apr 5;13(4):e067391. doi: 10.1136/bmjopen-2022-067391.
Infants born with critical congenital heart defects (CCHDs) have unique transitional pathophysiology that often requires special resuscitation and management considerations in the delivery room (DR). While much is known about neonatal resuscitation of infants with CCHDs, current neonatal resuscitation guidelines such as the neonatal resuscitation programme (NRP) do not include algorithm modifications or education specific to CCHDs. The implementation of CCHD specific neonatal resuscitation education is further hampered by the large number of healthcare providers (HCPs) that need to be reached. Online learning modules (eLearning) may provide a solution but have not been designed or tested for this specific learning need. Our objective in this study is to design targeted eLearning modules for DR resuscitation of infants with specific CCHDs and compare HCP knowledge and team performance in simulated resuscitations among HCPs exposed to these modules compared with directed CCHD readings.
In a prospective multicentre trial, HCP proficient in standard NRP education curriculum are randomised to either (a) directed CCHD readings or (b) CCHD eLearning modules developed by the study team. The efficacy of these modules will be evaluated using (a) individual preknowledge/postknowledge testing and (b) team-based resuscitation simulations.
This study protocol is approved by nine participating sites: the Boston Children's Hospital Institutional Review Board (IRB-P00042003), University of Alberta Research Ethics Board (Pro00114424), the Children's Wisconsin IRB (1760009-1), Nationwide Children's Hospital IRB (STUDY00001518), Milwaukee Children's IRB (1760009-1) and University of Texas Southwestern IRB (STU-2021-0457) and is under review at following sites: University of Cincinnati, Children's Healthcare of Atlanta, Children's Hospital of Los Angeles and Children's Mercy-Kansas City. Study results will be disseminated to participating individuals in a lay format and presented to the scientific community at paediatric and critical care conferences and published in relevant peer-reviewed journals.
患有严重先天性心脏缺陷(CCHD)的婴儿具有独特的过渡性病理生理学,这通常需要在产房(DR)中进行特殊的复苏和管理考虑。尽管人们对患有 CCHD 的新生儿复苏有很多了解,但目前的新生儿复苏指南(如新生儿复苏计划(NRP))并未包括针对 CCHD 的算法修改或教育内容。由于需要涉及的医疗保健提供者(HCP)数量众多,因此实施针对 CCHD 的新生儿复苏教育进一步受到阻碍。在线学习模块(eLearning)可能是一种解决方案,但尚未针对这种特定的学习需求进行设计或测试。我们在这项研究中的目标是为特定 CCHD 的 DR 复苏设计有针对性的 eLearning 模块,并比较接受这些模块的 HCP 与定向 CCHD 阅读的 HCP 在模拟复苏中的知识和团队表现。
在一项前瞻性多中心试验中,熟练掌握标准 NRP 教育课程的 HCP 被随机分配到以下两种方案之一:(a)定向 CCHD 阅读或(b)由研究团队开发的 CCHD eLearning 模块。将使用(a)个人预习/课后测试和(b)团队复苏模拟来评估这些模块的效果。
这项研究方案已获得九个参与机构的批准:波士顿儿童医院机构审查委员会(IRB-P00042003)、阿尔伯塔大学伦理委员会(Pro00114424)、威斯康星儿童医院 IRB(1760009-1)、全国儿童医院 IRB(STUDY00001518)、密尔沃基儿童医院 IRB(1760009-1)和德克萨斯大学西南医学中心 IRB(STU-2021-0457),并正在以下机构进行审查:辛辛那提大学、亚特兰大儿童保健、洛杉矶儿童医院和堪萨斯城儿童慈善会。研究结果将以通俗易懂的格式分发给参与的个人,并在儿科和危重病会议上向科学界报告,并发表在相关同行评议期刊上。