was 4% (n = 6). Details of these cases can be seen in table 1. Isolated IUGR, isolated prematurity, uncomplicated multiple birth and a gestational age of greater than 34 weeks were not associated with a severe abnormality. Conclusions Our study found a 4% severe anomaly rate in moderately preterm infants screened with CUS. But we found the infants in our study with a severe anomaly had clinically significant indications for scanning other than their prematurity and we believe they would have required scanning no matter their gestational age. These results suggest targeted screening may have been adequate to identify those at high risk. Further studies are required to delineate the true overall rate of CUS abnormalities in late preterm infants and to correlate these with neurodevelopmental outcomes. Background It is still uncertain if osteopathic manipulative treatment improves preterm clinical outcomes. Methods The present multi-centre randomised single blind parallel group clinical trial enrolled newborns who met the criteria for gestational age between 29 and 37 weeks without any congenital complication from 3 different public neonatal intensive care units. Preterm infants were randomly assigned to usual prenatal care (control group) or osteopathic manipulative treatment (study group). The primary outcome was the mean difference in length of stay between groups. Results A total of 695 newborns were randomly assigned to the study group (n = 352) and to the control group (n = 343). A statistical significant difference was observed between the two groups for the primary outcome (13.8 and 17.5 days for the study and control group respectively, p < 0.001, effect size: 0.31). Multivariate analysis showed a reduction of the length of stay of 3.9 days (-5.5 to -2.3, p < 0.001). Furthermore, there were significant reductions with treatment as compared to usual care in cost (difference between study and control group: 1,586.01€; 1,087.18 to 6,277.28; p < 0.001) but not in daily weight gain. The relative risk of developing any respiratory problem during the study period was 0.53 (0.42 to 0.64). Moreover, the estimated research period attributable risk was 47%. There were no complications associated to the intervention. Conclusions Osteopathic treatment reduced significantly the number of days of hospitalisation and costs on a large cohort of preterm infants. PO-0616
AimsHigh fidelity simulation is now well established as a teaching method for the whole multiprofessional healthcare team. In situ simulation allows the team to work through seldom seen scenarios, and make mistakes in a safe environment. It also allows team members to become familiar with each other, and the unit they work in, and uncovers potential problems within those units.There is no evidence to show that in situ high fidelity simulation training improves clinical outcomes, however the evidence still supports its use. Simulation training has been shown to enhance confidence, improve teamwork and patient safety, and highlight system or equipment failures within a team or clinical area.In our unit, the SimBaby equipment was available, but was only being used infrequently, and not to its full potential. Therefore, a quality improvement project was set up to undertake regular multidisciplinary in situ high fidelity simulation training in the neonatal unit.MethodsThe quality improvement model of ‘plan’, ‘do’, ‘study’, ‘act’, was used and worked through as the project was undertaken.A group of nursing and medical staff who were keen to become involved were identified. Those with prior experience of simulation training brought their expertise to the project, and most took the opportunity to attend simulation teaching days.The Simbaby (Laerdal) and resuscitation equipment was set up in an isolation room in the NICU. A ‘GoPro’ video recording device was set up to provide live recordings of the simulations, which can be played back during feedback. Several scenarios were developed, some with the use of the ‘simdesigner’ program.A questionnaire was devised to ask participants’ opinions about various aspects of the sessions. This is completed prior to the first simulation session, after three, and again after five sessions.We aim to carry out one simulation session per week, however this can vary depending on the availability of staff, and pressures elsewhere within the unit. At least two registrars or consultants lead each session, with at least one nurse, one registrar and one SHO participating. There is usually also a consultant to participate. There is then a feedback session and an opportunity to go over various aspects of the scenario at the end.ResultsOnly initial questionnaire results are available, so results are limited, however as simulation sessions are ongoing, more results are available each week. 6 participants have completed an initial questionnaire: 4 SHOs, 1 registrar, and 1 neonatal nurse. 5/6 participants were familiar with simulation training. 2/6 felt confident managing a neonatal airway, and 3/6 were confident with CPR. 1/6 could access the equipment they needed in the unit. 6/6 felt further training was needed, and 6/6 found the video review helpful. 5/6 felt that multidisciplinary simulation was helpful. Uptake on sessions has been excellent when the unit isn’t too busy.DiscussionThe lack of confidence in skills probably reflects the fact that most of the sample were SHOs, questioned early in the...
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