Zujkowski Michael, Ehrlich Shelley, Liu Chunyan, Sun Qin, Zackoff Matthew, Brady Jennifer M, Johnson Beth Ann, Mukthapuram Shanmukha
Department of Pediatrics, Division of Newborn Medicine, Tufts Medical Center, 800 Washington Street, Box 44, Boston, MA, 02111, USA.
Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Matern Child Health J. 2025 Jan;29(1):23-30. doi: 10.1007/s10995-024-04030-1. Epub 2024 Dec 31.
Labor and delivery (L&D) nurses are often responsible for initiating the critical first steps of the Neonatal Resuscitation Program (NRP). Identification of knowledge gaps and underlying reasons for NRP non-adherence is crucial for designing educational interventions.
A convenience sample of 37 L&D nurses from two delivery hospitals were enrolled. Participants completed a Likert scale survey capturing years of experience and comfort level in performing neonatal resuscitation followed by a video recorded standardized manikin-based simulation of a neonatal resuscitation. NRP adherence was assessed using an Observed Structured Clinical Examination (OSCE) assessment tool with prior validity evidence. Percentage of correctly completed OSCE items, median time to initiation of positive pressure ventilation (PPV), and achievement of effective PPV were analyzed using descriptive statistics.
Participants reported a median of 2.5 years of L&D experience, and a 4/6 confidence level for performing NRP. Fifty-seven percent of items (12/21) items were correctly completed. Participants took 55 s to initiate PPV with 57% initiating PPV within the target of 60 s. The time to effective PPV was 109 s, with 32% of participants achieving this within 60 s. Years of L&D experience had a strong correlation with percentage of correctly completed OSCE items (r = 0.63).
Despite high self-perceived confidence, initiating and achieving effective PPV within the 60 s time window mandated by NRP remains an area for significant improvement for L&D nurses. Next steps include the design and implementation of targeted training to address performance gaps and longer-term tracking for retention of knowledge.
分娩与接生（L&D）护士通常负责启动新生儿复苏计划（NRP）的关键初始步骤。识别知识差距以及NRP未得到遵循的潜在原因对于设计教育干预措施至关重要。
选取了来自两家分娩医院的37名L&D护士作为便利样本。参与者完成了一项李克特量表调查，该调查记录了他们在进行新生儿复苏方面的经验年限和舒适程度，随后进行了基于标准化人体模型的新生儿复苏视频模拟。使用具有先前效度证据的观察性结构化临床检查（OSCE）评估工具来评估NRP的遵循情况。使用描述性统计分析正确完成的OSCE项目的百分比、开始正压通气（PPV）的中位时间以及有效PPV的达成情况。
参与者报告的L&D经验中位数为2.5年，进行NRP的信心水平为4/6。57%的项目（12/21）被正确完成。参与者开始PPV的时间为55秒，其中57%在60秒的目标时间内开始PPV。达到有效PPV的时间为109秒，32%的参与者在60秒内达到这一目标。L&D经验年限与正确完成的OSCE项目的百分比有很强的相关性（r = 0.63）。
尽管自我感觉信心较高，但在NRP规定的60秒时间窗口内启动并实现有效的PPV，对于L&D护士来说仍是一个需要大幅改进的领域。下一步包括设计和实施针对性培训，以解决操作差距，并进行长期跟踪以巩固知识。
