The Implementation of a High Fidelity Neonatal/Pediatric Simulation Program to Improve Practitioner Competency During Advanced Life Support

Abstract

Background:

A Well-organized advanced high fidelity neonatal/pediatric simulation education (HFNPSE) will support the respiratory care student's development and retention of assessment and resuscitation skills. These skills will afford the student early recognition of a neonatal/pediatric patient who may require escalation in care as well as solidify their role as a respiratory care practitioner when advanced resuscitation measures are necessary. The purpose of this study is to provide graduating respiratory practitioner students with an effective HFNPSE model and evaluate the model's effectiveness in the areas of: team dynamics, skill, and confidence levels as compared to a traditional learning model, (lecture, hands-on practice, and mock codes with low fidelity mannikins).

Methods:

In fall of 2017 respiratory care students received Pediatric Advanced Life Support (PALS) and Neonatal Resuscitation Program (NRP) credentials by way of a traditional classroom learning model. In spring of 2018, the same respiratory care students were asked to complete a perception survey about their fall 2017 mock code experience. The areas examined were, team dynamics, algorithm information retention, confidence and skill levels. Then they reinstructed using advanced HFNPSE with high fidelity mannikins in a simulation lab setting; followed by another perception survey.

Results:

Perception survey results revealed a 48% increase in neonatal and a 47% increase in pediatric resuscitation confidence levels. There was a 27% increase in confidence providing positive pressure ventilation for both patient populations. Neonatal intubation confidence levels increased by 36% and by 37% in pediatrics. There was well over a 50% increase in both NRP and PALS information retention. A perception survey question asked students to compare traditional vs. HFNPSE and responses favored HFNPSE on the following strengths: realism, higher level of education, increased communication and algorithm information retention.

Conclusions:

Perception survey results suggest moderately high confidence in NRP and PALS skills as well as closed loop communication. If respiratory care students can retain code algorithm information they can move beyond traditional roles and assist the entire code team with all procedures; improving team dynamics. Frequent high fidelity neonatal/pediatric mock codes can improve practitioner competency, increase survival rates and assist in advancing the respiratory care profession.