A Needs Assessment of Labor and Delivery Nurses Performing NRP in the Delivery Room.

IF 1.8 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Maternal and Child Health Journal Pub Date : 2025-01-01 Epub Date: 2024-12-31 DOI:10.1007/s10995-024-04030-1
Michael Zujkowski, Shelley Ehrlich, Chunyan Liu, Qin Sun, Matthew Zackoff, Jennifer M Brady, Beth Ann Johnson, Shanmukha Mukthapuram
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引用次数: 0

Abstract

Introduction: 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.

Methods: 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.

Results: 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).

Discussion: 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.

产房分娩护士实施NRP的需求评估。
导言:分娩(L&D)护士通常负责启动新生儿复苏计划(NRP)的关键的第一步。识别知识差距和NRP不遵守的潜在原因对于设计教育干预措施至关重要。方法:选取两家分娩医院的37名妇产科护士作为方便抽样。参与者完成了一项李克特量表调查,记录了多年来进行新生儿复苏的经验和舒适度,随后播放了一段录像,记录了标准化的基于人体模型的新生儿复苏模拟。采用观察性结构化临床检查(OSCE)评估工具评估NRP依从性,并提供先前效度证据。使用描述性统计分析正确完成OSCE项目的百分比、开始正压通气(PPV)的中位数时间和实现有效的PPV。结果:参与者报告的L&D经验中位数为2.5年,执行NRP的置信度为4/6。57%的项目(12/21)正确完成。参与者在55秒内开始PPV, 57%的人在60秒内开始PPV。达到有效PPV的时间为109秒,32%的参与者在60秒内实现了这一目标。学习与发展经验的年数与正确完成欧安组织项目的百分比有很强的相关性(r = 0.63)。讨论:尽管有很高的自我认知信心,但在NRP规定的60年代时间窗口内启动并实现有效的PPV仍然是L&D护士需要显著改进的领域。接下来的步骤包括设计和实施有针对性的培训,以解决绩效差距和长期跟踪,以保留知识。
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来源期刊
Maternal and Child Health Journal
Maternal and Child Health Journal PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
3.20
自引率
4.30%
发文量
271
期刊介绍: Maternal and Child Health Journal is the first exclusive forum to advance the scientific and professional knowledge base of the maternal and child health (MCH) field. This bimonthly provides peer-reviewed papers addressing the following areas of MCH practice, policy, and research: MCH epidemiology, demography, and health status assessment Innovative MCH service initiatives Implementation of MCH programs MCH policy analysis and advocacy MCH professional development. Exploring the full spectrum of the MCH field, Maternal and Child Health Journal is an important tool for practitioners as well as academics in public health, obstetrics, gynecology, prenatal medicine, pediatrics, and neonatology. Sponsors include the Association of Maternal and Child Health Programs (AMCHP), the Association of Teachers of Maternal and Child Health (ATMCH), and CityMatCH.
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