Neonatal Resuscitation Plan: What's New and How to Implement Guideline Changes

Purpose for the program:   In 2010, the American Academy of Pediatrics significantly changed the Neonatal Resuscitation Program guidelines incorporating emerging evidence of best practices for the delivery of oxygen to the neonatal population.  Women and Infants Hospital (WIH) deliveries over 9000 infants annually; The NICU resuscitation team attends approximately 3000 deliveries and performs supportive measures on approximately 900 babies.

Proposed change:  Creating a comprehensive educational design would become paramount in successful dissemination of the impending practice changes. Three objectives were identified: 1) negotiate a uniform local interpretation of key NRP recommendations in the context of institutional standard practices, 2) create an educational intervention to efficiently and effectively disseminate changes to over 760 multispecialty staff, and 3) assess the adoption of new practices in clinical resuscitation events

Implementation, outcomes and evaluation:  The use of educational video recordings had served this institution well. With the extensive vastness of varying units in contact with neonates, multiple scenarios would need to be explored. Staff members were recruited for the video productions. To assist in strengthening the information being supplied, an outlined PowerPoint presentation was created which fostered continuity of instruction. A "train-the-trainer" model was developed to facilitate the needs of a large hospital-wide staff. A subcommittee of seven NRP Instructors would act as the front line educators of this instructional venture. Each department provided targeted champions who would be trained and tasked as “Super-Users

 Trainers introduced the material beginning on January 9th. By January 25th, the targeted goal of disseminating the information among 80% of WIH staff was attained. A committed group trained 610 Neonatal resuscitation providers within 16 days! Compliance data collection was initiated to assess the success of creating a culture change in neonatal practices

Implications for nursing practice:  As children, we all had an opportunity to play the game of telephone; the premise being that one person share a piece of information with another and that piece of information is shared with another, so forth. By the end of the communication it is found that the final message in no way resembles the original message. It is with this concept in mind that many struggle when the task of disseminating information to large groups of employees is required. Feedback from this endeavor has been fruitful; corroborating data reported by event observations has spoken to retention and implementation of theory into practice and affirmation of a job well done.

Keywords: Neonatal Resuscitation, Pulse Oximetry, Oxygen, Saturation, Prematurity, Newborn