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


Poster Presentation

Purpose for the Program

In 2010, the American Academy of Pediatrics significantly changed the Neonatal Resuscitation Program (NRP) guidelines by incorporating emerging evidence of best practices for the delivery of oxygen to the neonatal population. Women and Infants Hospital (WIH) delivers more than 9,000 infants annually; the neonatal intensive care unit resuscitation team attends approximately 3,000 deliveries and performs supportive measures on approximately 900 infants.

Proposed Change

Creating a comprehensive educational design would become paramount in successful dissemination of the impending practice changes. Three objectives were identified: (a) negotiate a uniform local interpretation of key NRP recommendations in the context of institutional standard practices; (b) create an educational intervention to efficiently and effectively disseminate changes to more than 760 multispecialty staff; and (c) assess the adoption of new practices in clinical resuscitation events.

Implementation, Outcomes, and Evaluation

The use of educational video recordings has 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 frontline educators of this instructional venture. Each department provided targeted champions who would be trained and tasked as “super-users.”

Trainers introduced the material on January 9. By January 25, 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, and 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 is disseminating information to large groups of employees. 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.