Are You Ready for “the Change?” Embracing the NRP Guidelines of Simulation and Debrief

Purpose for the program: Change is an inevitable, on-going process in the healthcare profession. When significant practice changes occur, opportunities present for nursing leaders to champion innovative methods for overall performance improvement. The Neonatal Resuscitation Program (NRP) has offerd a standardized approach to the teaching and practice of neonatal resuscitation since 1987.  This program has over 27,000 instructors, who train more than 3 million providers. NRP guidelines were updated in 2010 through evidence-based practice causing a need for new teaching methods.  Two labor & delivery nurses recognized the chance to revamp the way NRP is taught within their level III tertiary facility.

Proposed change: Traditionally, NRP instructors have conducted classes through a lecture, video, testing format, followed by a megacode to practice skills.  The current changes by the American Academy of Pediatrics to the NRP guidelines, has brought about a new education methodology.  Instructors need to shift from teachers to facilitators; which requires new skills for successful education.  Each instructor previously had their own style of teaching, emphasized different points of NRP and held megacodes that did not always offer the most effective cognitive, technical and behavioral skills necessary for newborn resuscitation.  The proposed change includes standardizing 2-3 scenarios of infant resuscitation, practicing together as an instructor group, and learning how to be less of a teacher and more of a facilitator so that participants will assume more of the responsibility for their own learning.

Implementation, outcomes and evaluation: Initially, three standardized resuscitation scenarios were created.  Next, a workshop for all unit NRP instructors was scheduled. Instructors were able to practice together learning how to become effective facilitators of education. Proposed outcomes include successfully bringing current NRP instructors together, establish momentum for change and refocus on the fundamentals of neonatal resuscitation, increase the challenge for participants by their biennial NRP experience and ultimately optimize improvements in the acquisition of improved performance in neonatal resuscitation. Staff and participants will be surveyed regarding their experience in this updated learning format.

Implications for nursing practice: The main goal for nursing is to create a consistent learning atmosphere, equally stimulating for all participants by a core group of instructors. Then utilize adult learner methods to optimize improved performance in neonatal resuscitation; promoting safe, reliable practice.  Finally, empower learners to champion excellence in the care of newborns through instructor facilitation.

 Keywords: performance improvement, innovative methods, change, simulation, debrief