Low-dose high-frequency training

Newborn healthcare providers must be well-trained and skilled to initiate the delivery of adequate and effective positive pressure ventilation (PPV) to ensure newborn survival and reduce long-term morbidity. Expert consesus recommends resuscitation psychomotor skill training and validation at regular time intervals in order to improve performance and mitigate recognized barriers.

Niles et al, identifies that resuscitation competency is transient after standard training and that studies have reported that implementation of a training program consisting of high-frequency, short-duration, psychomotor skill “Refreshers” can improve resuscitation skills when utilized as a supplement to standard resuscitation education. 

This study was conducted in the Labor and Delivery Unit (LDU) and Intensive Care Nursery (ICN) in a tertiary academic hospital. The objective of their study was to assess the effectiveness of a neonatal resuscitation simulation educational program featuring brief, repeated PPV-Refresher psychomotor skill practice to improve PPV performance among front-line nurses caring for newborns. Nurses completed a PPV skills assessment upon enrollment (Baseline) and three months after the baseline assessment. Data on inflation volume and ventilation rate were collected and compared. During the study period of 3 months, at least 75 PPV-refresher courses were completed. 

FINDINGS

Niles and colleagues found that implementation of a brief PPV-Refresher psychomotor skill program significantly improved the total number of PPV delivered and number of Target PPV (volume 10-21 mL) on a manikin. 

Although they were unable to determine an optimal PPV-Refresher frequency to improve performance, their data suggests that completing one PPV-Refresher session quarterly may be sufficient to improve and maintain the number and quality of PPV delivered. 

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Practice Makes perfect – Monivent NEO TRAINING

Simulation training in a safe environment to practice and improve manual ventilation skills can improve confidence and competence in practice.

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