Telecoaching Improves Positive Pressure Ventilation Performance During Simulated Neonatal Resuscitations.

Introduction: Positive pressure ventilation (PPV) is a critical skill for neonatal resuscitation. We hypothesized that telecoaching would improve PPV performance in neonatal providers during simulated neonatal resuscitations. Setting: Level IV neonatal intensive care unit (NICU). Methods: This prospective crossover study included 14 experienced NICU nurses and respiratory therapists who performed PPV on a mannequin that recorded parameters of ventilation efficiency. Participants were randomized to practice independently (control) or with live feedback from a remote facilitator through audiovisual connection (intervention) and then switched to the opposite group. Participants' mask leak percentage, ventilation rates, and pressure delivery were analyzed. Results: The primary outcome of mask leak percentage was significantly increased in the telecoaching group (19% [interquartile range {IQR} 14-59.25] vs. 100% [IQR 88-100] leak, p = 0.0001). The secondary outcome of peak inspiratory pressure (PIP) delivery was also increased (median 27.6 [IQR 23.5-34.7] vs. 23.3 [IQR 19.1-32.8] cmH2O, p < 0.001). Differences in ventilation rates were not statistically significant (55 vs. 58 breaths/min, p = 0.51). Conclusion: Participants demonstrated better PPV performance during telecoaching with less mask leak. The intervention group also had higher measured peak inspiratory pressures. Telecoaching may be a feasible method to provide real-time feedback to health care providers during simulated neonatal resuscitations. Hypothesis: Neonatal providers who receive telecoaching during simulated resuscitations will perform PPV more effectively than those who do not receive telecoaching.

A Web-Based Nursing Education for Thermoregulation.

Neonatal nurses provide essential care in the hospital setting for improving infants' morbidity and mortality outcomes by preventing hypothermia after delivery. This quality improvement project describes the development and implementation of a web-based educational activity, demonstrating that online education effectively increases nurse knowledge and commitment to thermoregulation practices. A learning management system provides nursing professional development practitioners an effective method of improving nursing knowledge using a web-based educational curriculum in the clinical setting.