A survey of neonatal resuscitation in Spain: gaps between guidelines and practice

Iriondo, Martín; Thió, Marta; Buron, Emmanuel; Salguero, E; Aguayo, J.; Vento, Máximo

doi:10.1111/j.1651-2227.2009.01233.x

Cited by 61 publications

(36 citation statements)

References 27 publications

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“…We found a high level of uniformity on knowledge, skills, and key competencies needed to practice neonatology at a tertiary care level. This is not surprising since medical care of extremely preterm infants and sick newborns is essentially the same across Europe [5,6,7]. The lack of coherence with the ESN Curriculum on specific skills (EEG, suprapubic bladder puncture, etc.)…”

Section: Discussionmentioning

confidence: 99%

The European Database for Subspecialist Training in Neonatology – Transparency Achieved

et al. 2012

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Background: The European Society for Neonatology (ESN) developed a curriculum for subspecialist training in Europe recommending standards for national neonatal training programmes. We speculate whether these official recommendations are widely accepted or used in practice. Objectives: To characterize the variation in national neonatal training programmes, to enhance transparency, and to compare them to the ESN Curriculum. Methods: We constructed a database based on the backbone of the ESN Curriculum: (1) training – knowledge, (2) training – skills, (3) key competencies, (4) personal development, and (5) recording of progress. National neonatal representatives from all 30 member states of the Union of European Medical Specialties (UEMS) provided data on national training programmes. Results: Although only one country (3%) based its neonatology training entirely on the ESN Curriculum, we found high levels of uniformity among the UEMS member countries regarding knowledge, skills, and key competencies needed to practice neonatology at a tertiary care level. Discrepancy was encountered on ethical and legal issues and on personal development of the trainees. Mentoring and professional evaluation was generally not implemented in the participating countries. Conclusions: There is an awareness and readiness to focus on educational demands for neonatal trainees. Further discussions about the overall educational goals of neonatal training and the essence of practicing neonatology in each country are needed. The ESN will undertake this process to provide an updated and effective syllabus aimed to harmonize care and outcomes for babies and their families across Europe.

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Section: Discussionmentioning

confidence: 99%

The European Database for Subspecialist Training in Neonatology – Transparency Achieved

et al. 2012

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“…At the time of completion of our course, the latest edition of the NRP textbook had not yet been released; however, the Simulation has been demonstrated to be a useful tool during the period of residency [15][16][17], but its utility is not limited to those years of training or to inexpert pro-principal changes could be previewed by reading the AAP and AHA guidelines, and many articles anticipated the inclusion of simulation as an educational tool [22]. Recently, we have witnessed the local adaptation of our country to these new international changes, and simulation and debriefing techniques are mentioned with their application to neonatal resuscitation training [23].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of participants' feedback after a simulation-based training in neonatal resuscitation using a realistic delivery room

Ávila-Álvarez¹,

Gonzalez-Rivera²,

Fernandez-Trisac³

et al. 2012

OJPed

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BACKGROUND: Low-frequency and high-risk situations, such as neonatal resuscitation, are the ideal targets for simulation-based learning. The aim of this paper is to present the structure of our internal neonatal resuscitation training program, using a realistic, simulated delivery room, and to present the participants' opinions about teamwork, emotional stress, and their subjective ability to face a resuscitation. METHODS: We administered a training course to 24 doctors and midwives. One of the simulation classrooms was modified to appear similar to a real delivery room. Four scenarios were conducted using a previously designed checklist of primary and secondary goals. Upon completion, all students participated in a debriefing session with the help of a video review. RESULTS: Students rated the achievement of their previously defined goals on a scale of 1 to 5. Grouping together the percentages of the highest ratings (Categories 4 and 5), 83.4% (20/24) of the students considered the course useful for acquiring clinical skills. For 87.5% (21/24) of the students, the scenarios simulated real clinical situations, the room properly simulated a real delivery room, and the course improved the students' ability to work in a team. For 66.6% (16/24) of the students, the course improved their stress in confronting neonatal resuscitation. Initially, only 33.3% (8/24) of the students considered themselves very capable or fully able to cope with a resuscitation. After the course, that percentage rose to 62.5% (15/24). CONCLUSIONS: The incorporation of simulation-based learning into neonatal resuscitation teaching programs, using realistic scenarios, is useful and offers the possibility of acquiring technical skills, but it also allows for the improvement of teamwork and the adoption of different roles and positive attitudes towards emotional stress.

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“…Continuous positive airway pressure (CPAP) in the delivery room has gained popularity over the past years, particularly for the preterm population. But its use varies between 50 and 85% across countries, with units setting different gestational age thresholds (anywhere from 24-32 weeks) above which they would attempt CPAP [2,3,5,9]. For those infants who get intubated, 3-45% of units have reported using CO 2 detectors [4,[6][7][8][9].…”

Section: Respiratory Care Management In the Delivery Roommentioning

confidence: 99%

“…Despite evidence-based recommendations on the use of pulse oximetry (PO), oxygen blenders and resuscitation of term infants with room air [1], some units have not yet adopted these practices. Routine use of PO and O 2 blenders ranges from 30 to 100% and 36 to 100% across units, respectively [2,[5][6][7][8][9][10]. Although guidelines recommend preductal saturation measurements, one survey showed that only 37% of units placed their saturation probes correctly [3].…”

Section: Respiratory Care Management In the Delivery Roommentioning

confidence: 99%

“…Units provide positive pressure ventilation using various methods, including the flow-inflating bag (2-63%), self-inflating bag (6-96%), T-piece/Neopuff (1-79%) and ventilator (16-49%) [2][3][4][5][6][7][8][9]. These can be delivered via face mask, binasal prongs, single nasal prong or a nasopharyngeal tube.…”

Section: Respiratory Care Management In the Delivery Roommentioning

confidence: 99%

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Respiratory Care Protocols in Neonatal Intensive Care

Shalish¹,

Anna²

2016

Respiratory Management of Newborns

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Neonatal respiratory care involves physicians with variable backgrounds treating multiple respiratory problems and populations with a number of invasive and noninvasive devices and strategies. Unfortunately, there is a lack of strong evidence to guide the most adequate management for several specific situations. Altogether, this complexity leads to significant practice variability that can affect patient and health care outcomes. Respiratory care protocols, guided by evidence and/or consensus, are an attractive solution to promote standardization of care and reduction of unnecessary practice variations. Indeed, despite the limited evidence supporting the use of respiratory protocols in neonates, a significant number of units have already developed and implemented them into clinical practice. Respiratory care protocols appear to promote evidence-based practices, discourage outdated approaches and ultimately improve patient safety.

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A survey of neonatal resuscitation in Spain: gaps between guidelines and practice

Cited by 61 publications

References 27 publications

The European Database for Subspecialist Training in Neonatology – Transparency Achieved

The European Database for Subspecialist Training in Neonatology – Transparency Achieved

Evaluation of participants' feedback after a simulation-based training in neonatal resuscitation using a realistic delivery room

Respiratory Care Protocols in Neonatal Intensive Care

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