Video recording of neonatal resuscitation: A feasibility study to inform widespread adoption

Abstract

AIMTo determine the feasibility of introducing video recording (VR) of neonatal resuscitation (NR) in a perinatal centre.METHODSThis was a prospective cohort quality improvement study on preterm infants and their caregivers. Based on evidence and experience of other centers using VR intervention, a contextually relevant implementation and evaluation strategy was designed in the planning phase. The components of intervention were pre-resuscitation team huddle, VR of NR and video debriefing (VD), all occurring on the same day. Various domains of feasibility and sustainability as well as feasibility criteria were predefined. Data for analysis was collected using quantitative and qualitative methods.RESULTSSeventy-one caregivers participated in VD of 14 NRs facilitated by six trained instructors. Ninety-one percent of caregivers perceived enhanced learning and patient safety and, 48 issues were identified related to policy, caregiver roles, and latent safety threats. Ninety percent of caregivers expressed their willingness to participate in VD activity and supported the idea of integrating it into a resuscitation team routine. Eighty-three percent and 50% of instructors expressed satisfaction with video review software and quality of audio VR. No issues about maintenance of infant or caregivers’ confidentiality and erasure of videos were reported. Criteria for feasibility were met (refusal rate of < 10%, VR performed on > 50% of occasions, and < 20% caregivers’ perceiving a negative impact on team performance). Necessary adaptations to enhance sustainability were identified.CONCLUSIONVR of NR as a standard of care quality assurance activity to enhance caregivers’ learning and create opportunities that improve patient safety is feasible. Despite its complexity with inherent challenges in implementation, the intervention was acceptable, implementable, and potentially sustainable with adaptations.

Benefits of recording and reviewing neonatal resuscitation: the providers’ perspective

“…Gelbart et al reported that most staff members were willing to participate 20. Shivananda et al recently reported that 90% of questioned providers considered recording and reviewing acceptable 12. This suggests a growing base of evidence that recording and reviewing neonatal resuscitation is acceptable for neonatal care providers, supporting the recommendation for implementation made by the providers participating in our study.…”

“…Enhanced learning after reviewing actual resuscitation was reported by Shivananda et al and Skåre et al 12 13. Many studies highlight the clear educational benefits of recording and reviewing actual care 14.…”

Video performance-debriefings and ventilation-refreshers improve quality of neonatal resuscitation

“…In the group with heart rate <100 bpm, time to heart rate ≥100 bpm was 132 (87-161) pre-vs. 110 (97-151) seconds post-implementation (p=0.99). The time to evaluate first heart rate was 17 (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24) pre-vs. 16 (12)(13)(14)(15)(16)(17)(18)(19)(20) seconds post-implementation, respectively (p=0.61) ( Table 2). Apgar scores at 5 minutes improved significantly from 7 (7-8) pre-to 8 (8-8) post-implementation (p=0.003) ( Table 1).…”

“…In an effort to improve training, numerous studies suggest "just-in-time" (just prior to procedure) and "justin-place" (within the clinical environment) simulation training may be an effective concept to improve clinical skills [10][11][12]. Video recording has been used to evaluate teamwork and guideline compliance during both simulated and real neonatal resuscitation and provided insights to targeted education [13][14][15][16][17]. Video may be a feasible method to assess performance and facilitate quality improvement [18].…”

Accuracy of real-time delivery room resuscitation documentation

“…Video recording captures more objective and consistent information than both retrospective and in-person documentation 2–4. However, technical and implementation barriers limit the reliability of video recording,5 as evident by the seven resuscitations excluded from our study due to incomplete recordings. A combination of both video recording and real-time documentation may provide the most complete and accurate method to document neonatal resuscitation.…”