University of Texas Health Science Center, Houston
Houston, Texas, 77030, United States
Completed
NCT Number: NCT00651794
Improving Teamwork for Neonatal Resuscitation
The Neonatal Resuscitation Program (NRP) is the curriculum used to teach providers how to care for newborns in the delivery room. Breakdowns in teamwork and communication contribute to NRP quality problems. Adding teamwork instruction to NRP may be a method to improve communication, teamwork, and the overall quality of neonatal resuscitation. This study uses simulation to incorporate team training into NRP and to evaluate both the effectiveness and duration of the team training. Furthermore, because high fidelity simulation is very expensive and not widely available, we will compare NRP with low fidelity team training to NRP with high fidelity team training.
Our hypotheses are:
1. NRP with low fidelity team training results in a) better teamwork, and b) better quality of care compared with standard NRP. 2. NRP with high fidelity team training does not result in better teamwork or better quality of care than NRP with low fidelity simulation. 3. NRP with high fidelity team training does not produce a longer lasting effect on teamwork than NRP with low fidelity simulation.
Completed
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Notify MeKey information
Conditions
Sex eligibility
All sexes
Study type
Interventional
Phase
Not applicable
Primary location
Who can participate
Healthy volunteers accepted: Yes
Only the study team can determine whether someone qualifies for participation.
Inclusion criteria
- New interns that enter pediatrics, family medicine, obstetrics/gynecology, and emergency medicine.
Exclusion criteria
-
Treatment and study plan
Teamwork training
BehavioralCrew Resource Management (CRM) is an aviation training program mandated for all crew members that teaches human factors concepts, communication skills, and teamwork behaviors that can prevent and manage error. Over the last six years the study team has translated these behaviors to neonatal resuscitation and demonstrated that they can be reliably measured. Adding teamwork instruction to the existing NRP, based upon CRM, may be a method to improve communication, teamwork, and the overall quality of neonatal resuscitation.
Standard NRP curriculum
BehavioralThe existing NRP course, taught to most caregivers in the United States who care for newborns, focuses on teaching the technical aspects of neonatal resuscitation with little attention paid to communication and teamwork.
Skills practice with low-fidelity mannequin
BehavioralSkills practice with high-fidelity mannequin
BehavioralSimBaby mannequins (Laerdal Medical Corp, Stavanger, Norway) were used in the high-fidelity skills stations. These mannequins have simulated heart tones, breath sounds, pulses, and cries.
Primary outcomes
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Teamwork Event Rate
Time frame: During the megacode, which was performed about 1 hour after the training
The teamwork event rate was calculated by summing the number of scored teamwork events (sharing information, inquiry, assertion, teaching/advising, and evaluation of plans) and dividing by the total resuscitation time (in minutes).
Secondary outcomes
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Percentage of Time Spent on Workload Management
Time frame: During the megacode, which was performed about 1 hour after the training
Workload management percentage was calculated by summing the total time the team demonstrated workload management behavior and dividing by the total resuscitation time.
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Percentage of Time Spent on Vigilance
Time frame: During the megacode, which was performed about 1 hour after the training
Vigilance percentage was calculated by summing the total time the team demonstrated vigilance behavior and dividing by the total resuscitation time.
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Neonatal Resuscitation Program (NRP) Quality as Assessed by NRP Performance Score
Time frame: During the megacode, which was performed about 1 hour after the training
We analyzed 2 measures of NRP quality: performance score and resuscitation duration. The performance score was calculated by averaging the scores (ranging from 0 to 2 - higher values represent a better outcome) for each NRP step (some of which occurred multiple times). Those scores were summed and divided by the total possible score (2 times the number of steps that should have been performed). When a step was not indicated for the specific resuscitation scenario (e.g., meconium aspiration), that step was not scored by the observers and it was not included in the denominator for performance calculation. This produced a measure of performance percentage ranging from 0 percent to 100 percent (higher values represent a better outcome) for each resuscitation.
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Neonatal Resuscitation Program (NRP) Quality as Assessed by Resuscitation Duration
Time frame: During the megacode, which was performed about 1 hour after the training
Resuscitation duration is time required to complete the resuscitation. The total duration for each resuscitation was calculated from the start of the instructor's reading of the scenario to the team's statement that the infant should be transferred to the NICU. When any teaching moments occurred during the simulation, the total teaching time was subtracted from the resuscitation duration.
Sponsors and collaborators
Lead sponsor
The University of Texas Health Science Center, Houston
Other
Registry information
Important dates
- Study start
- 2007
- Primary completion
- 2012
- Study completion
- 2012
- First posted
- Apr 3, 2008
- Registry last updated
- Oct 19, 2017
OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.
View the official ClinicalTrials.gov record (opens in a new tab)This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.