The SuPPORT project: Supporting Parents and Professionals through NeOnatal resuscitation in theatre. Phases 1 and 2: qualitative synthesis and capture of current practice

Background

The anaesthetic team routinely act as the initial information providers to mothers and birth partners during neonatal resuscitation in obstetric theatre. This situation presents unique, under-researched communication challenges. Through exploration of parental and professional voices, we aimed to describe the determinates of high-quality communication during this time.

Methods

This was a two-phase, mixed-method study. In phase 1, a scoping exercise involved parents with personal experience of neonatal resuscitation in theatre; In phase 2, an anaesthetic staff questionnaire explored professional experiences and communication during neonatal resuscitation in theatre across all Welsh National Health Service (NHS) hospitals with secondary obstetric services.

Results

The qualitative framework analysis revealed overlapping themes from 112 parent responses (phase 1) and 175 anaesthetic staff responses (phase 2). In phase 1, parents reported positive experiences reflecting their desire for clear, honest, timely information delivered compassionately, alongside the use of photos and videos. Challenging experiences highlighted a perceived lack of information, insensitive, impersonal communication and processes, the use of jargon and a challenging environment. In phase 2, the staff demonstrated high exposure to, and negative emotional impact from neonatal resuscitation experiences. Communication barriers included restricted situational insight, emotional stress alongside complex care delivery. Strategies to assist communication included actively seeking information, providing a compassionate approach, offering assurances and managing the environment. Training in communication during neonatal resuscitation was reported by 4% (7/175) of staff.

Conclusion

In this mixed-model qualitative study, we identified that mothers and birth partners desired clear, honest updates delivered with compassion. Assurances of high-quality care provision for their baby alongside avoidance of false reassurance were important. Anaesthetic staff recognised their role in providing this information but reported lacking confidence to do so and would welcome training. The reported results can be used to inform the development of evidenced-based tools and training.