Real-Time Safety Audits of Neonatal Delivery Room Resuscitation Areas: Are We Sufficiently Prepared?

Abstract

Objective This study aimed to use real-time safety audits to establish whether preparation of the equipment required for the stabilization and resuscitation of newborns in the delivery room areas is adequate. Study Design This was a descriptive, multicenter study performed at five-level III-A neonatal units in Madrid, Spain. For 1 year, one researcher from each center performed random real-time safety audits (RRTSAs), on different days and during different shifts, of at least three neonatal stabilization areas, either in the delivery room or in the operating room used for caesarean sections. Three factors in each area were reviewed: the set-up of the radiant warmer, the materials, and medication available. The global audit was considered without defect when no errors were detected in any of the audited factors. Possible differences in the results were analyzed as a function of the study month, day of the week, or shift during which the audit had been performed. Results A total of 852 audits were performed. No defects were detected in any of the three factors analyzed in the 534 (62.7%, 95% confidence interval [CI]: 59.3–65.9) cases. Slight defects were detected in 98 (11.5%, 95% CI: 9.4–13.8) cases and serious defects capable of producing adverse events in the newborn during resuscitation were found in 220 (25.8%, 95% CI: 22.9–28.9) cases. No statistically significant differences in the results were found according to the day of the week or time during which the audits were performed. However, the percentage of RRTSAs without defect increased as the study period progressed (first quarter 38.1% vs. the last quarter 84.2%; p < 0.001). Conclusion The percentage of adequately prepared resuscitation areas was low. RRTSAs made it possible to detect errors in the correct availability of the neonatal stabilization areas and improved their preparation by preventing errors from being perpetuated over time. Key Points

What Is the Opinion of the Health Care Personnel Regarding the Use of Different Assistive Tools to Improve the Quality of Neonatal Resuscitation?

“…They are cost-effective and easy to conduct. Their use in the neonatal healthcare setting is not widespread, and to our knowledge, there are no publications that have analyzed the satisfaction of healthcare teams with their use (5)(6)(7)(8)(9)(10).…”

“…Their use in the neonatal health care setting is not widespread, and to our knowledge, there are no publications that have analyzed the satisfaction of health care teams with their use. [5][6][7][8][9][10] This study aims to analyze the perceived quality of neonatal resuscitation by health care personnel responsible for stabilizing newborns at the moment of birth. This analysis follows the implementation of an assistance toolkit in resuscitations of infants under 32 weeks of gestational age (<32 wGA), which includes RRSA of resuscitation stations in the delivery room, prestabilization checklists, and postresuscitation debriefings.…”