Anderson Nicole M, Kitchen Andrea, McKenzie Amy, Joynt Chloe
Division of Neonatology, Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.
Alberta Health Services, Stollery NICU, Edmonton, AB, Canada.
J Perinatol. 2024 Dec 10. doi: 10.1038/s41372-024-02192-y.
The design, implementation and audit of a multidisciplinary advanced neonatal resuscitation education initiative for "in unit" events in a quaternary NICU over a 9-year period, divided into 3-year epochs of "pre", "implementation" and "maintenance" is described.
A didactic and simulation quality improvement initiative focused on teaching and reinforcing specific algorithms endorsed by the American Heart Association (AHA) to target resuscitation needs of older neonates including surgical and cardiac conditions. Qualitative and quantitative data pre and post implementation was audited.
Post education implementation, team members performed quicker hemodynamic assessments and applied CPR and/or bolus epinephrine correctly in higher proportions during acute events. During supraventricular tachycardia, vagal maneuver use and medication administration time improved.
Advanced neonatal resuscitation education and reinforcement targeted for event etiology, allow for AHA algorithms to be successfully taught and performed within a quaternary NICU with improvement in hemodynamic assessments and AHA algorithm implementation.
描述一项针对四级新生儿重症监护病房（NICU）“单元内”事件的多学科高级新生儿复苏教育计划的设计、实施和审核，该计划为期9年，分为“预”、“实施”和“维持”三个3年阶段。
一项教学与模拟质量改进计划，重点是教授和强化美国心脏协会（AHA）认可的特定算法，以满足包括外科和心脏疾病在内的较大新生儿的复苏需求。对实施前后的定性和定量数据进行审核。
教育实施后，团队成员在急性事件中进行血流动力学评估的速度更快，正确应用心肺复苏（CPR）和/或大剂量肾上腺素的比例更高。在室上性心动过速期间，迷走神经手法的使用和药物给药时间有所改善。
针对事件病因的高级新生儿复苏教育和强化，使得AHA算法能够在四级NICU中成功教授和实施，同时血流动力学评估和AHA算法实施得到改善。
