ObjectiveTo evaluate the parent and staff experience of a secure video messaging service as a component of neonatal care.DesignMulticentre evaluation incorporating quantitative and qualitative items.SettingLevel II and level III UK neonatal units.PopulationFamilies of neonatal inpatients and neonatal staff.InterventionUse of a secure, cloud-based asynchronous video messaging service to send short messages from neonatal staff to families. Evaluation undertaken July–November 2019.Main outcome measuresParental experience, including anxiety, involvement in care, relationships between parents and staff, and breastmilk expression.ResultsIn pre-implementation surveys (n=41), families reported high levels of stress and anxiety and were receptive to use of the service. In post-implementation surveys (n=42), 88% perceived a benefit of the service on their neonatal experience. Families rated a positive impact of the service on anxiety, sleep, family involvement and relationships with staff. Qualitative responses indicated enhanced emotional closeness, increased involvement in care and a positive effect on breastmilk expression. Seventy-seven post-implementation staff surveys were also collected. Staff rated the service as easy to use, with minimal impact on workload. Seventy-one percent (n=55) felt the service had a positive impact on relationships with families. Staff identified the need to manage parental expectations in relation to the number of videos that could be sent.ConclusionsAsynchronous video messaging improves parental experience, emotional closeness to their baby and builds supportive relationships between families and staff. Asynchronous video supports models of family integrated care and can mitigate family separation, which could be particularly relevant during the COVID-19 pandemic.

IntroductionNeonatal intubation is a challenging skill to acquire. A randomised controlled trial (RCT) found junior trainees had higher intubation success rates if their supervisor shared their airway view on a videolaryngoscope screen compared with intubations where the supervisor could not see the videolaryngoscope screen. The intubations in the trial were supervised by a group of experienced neonatologists who developed an intubation teaching package that aimed to be informative, consistent and supportive. We surveyed the trainees to assess their experiences of the intubation attempts.MethodsTrainees participating in the RCT completed questionnaires anonymously after each intubation attempt. Questionnaires used 5-point Likert scales and free comment sections. Quantitative analysis was performed using descriptive statistics. In a qualitative analysis, free comments were coded to identify central recurring themes.ResultsTwo hundred and six questionnaires were completed by 36 trainees. The majority reported that the guidance received during intubation was helpful, the postprocedure feedback was educational and their confidence levels were increased. Trainees appreciated a controlled environment and calm, consistent guidance. They found intubations in the delivery room, those involving unstable infants, large audiences and parental presence more stressful. Responses were positive whether the videolaryngoscope screen was visible or covered, emphasising the importance of consistent guidance. Overall, 16% of intubations were reported as intimidating.ConclusionThe shared airway view offered by videolaryngoscopy was well received. In addition, taking measures to control the setting, with standardised guidance and feedback, improved confidence and created a more positive learning experience.

Neonatal intubation is an essential but difficult skill to learn. Videolaryngoscopy allows the airway view to be shared by the intubator and supervisor and improves intubation success. Ideally, a videolaryngoscope (VL) should be usable as a conventional laryngoscope (CL). The aims of this report were to describe differences in the shape of currently available CL and VL blades and to compare the direct airway view obtainable on a neonatal manikin with different laryngoscope blades.Three main differences were observed; compared with CL, the VL blades have a reduced vertical height, a curved tip and curved body. The direct airway view obtained by the VL is narrower than that obtained with the CL, although the corresponding view on the VL screen is maintained.Minor adaptation of intubation technique may be required when using a VL. Modifying VL blades to reduce these differences may improve their usefulness as an intubation training tool.

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