Implementation and effectiveness of a video‐based debriefing programme for neonatal resuscitation

Background Approximately 5%–10% of newly born babies need intervention to assist transition from intra‐ to extrauterine life. All providers in the delivery ward are trained in neonatal resuscitation, but without clinical experience or exposure, training competency is transient with a decline in skills within a few months. The aim of this study was to evaluate whether neonatal resuscitations skills and team performance would improve after implementation of video‐assisted, performance‐focused debriefings. Methods We installed motion‐activated video cameras in every resuscitation bay capturing consecutive compromised neonates. The videos were used in debriefings led by two experienced facilitators, focusing on guideline adherence and non‐technical skills. A modification of Neonatal Resuscitation Performance Evaluation (NRPE) was used to score team performance and procedural skills during a 7 month study period (2.5, 2.5 and 2 months pre‐, peri‐ and post‐implementation) (median score with 95% confidence interval). Results We compared 74 resuscitation events pre‐implementation to 45 events post‐implementation. NRPE‐score improved from 77% (75, 81) to 89% (86, 93), P < 0.001. Specifically, the sub‐categories “group function/communication”, “preparation and initial steps”, and “positive pressure ventilation” improved (P < 0.005). Adequate positive pressure ventilation improved from 43% to 64% (P = 0.03), and pauses during initial ventilation decreased from 20% to 0% (P = 0.02). Proportion of infants with heart rate > 100 bpm at 2 min improved from 71% pre‐ vs. 82% (P = 0.22) post‐implementation. Conclusion Implementation of video‐assisted, performance‐focused debriefings improved adherence to best practice guidelines for neonatal resuscitation skill and team performance.