Trial Outcomes & Findings for Improving Teamwork for Neonatal Resuscitation (NCT NCT00651794)

NCT ID: NCT00651794

Last Updated: 2017-10-19

Results Overview

The teamwork event rate was calculated by summing the number of scored teamwork events (sharing information, inquiry, assertion, teaching/advising, and evaluation of plans) and dividing by the total resuscitation time (in minutes).

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

100 participants

Primary outcome timeframe

During the megacode, which was performed about 1 hour after the training

Results posted on

2017-10-19

Participant Flow

All incoming interns for pediatrics, combined pediatrics and internal medicine, family medicine, emergency medicine, and obstetrics and gynecology who began training in June 2007 or June 2008 and had not previously completed NRP certification were eligible for participation in the study.

100 interns were consented, and 98 completed the initial megacode (that is, the initial simulation with a mannequin that was observed and scored). Baseline characteristics are reported for the 98 who completed the initial megacode.

Participant milestones

Participant milestones
Measure
Control (NRP Curriculum With LFT and no Team Training)
Standard NRP curriculum with no team training; simulated resuscitation using low-fidelity simulators
NRP With LFT and Team Training
Standard NRP curriculum + team training; simulated resuscitation using low-fidelity simulators
NRP With HFT and Team Training
Standard NRP curriculum + team training; simulated resuscitations using high-fidelity simulators
Overall Study
STARTED
36
31
31
Overall Study
COMPLETED
15
9
10
Overall Study
NOT COMPLETED
21
22
21

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Improving Teamwork for Neonatal Resuscitation

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Control (NRP Curriculum With LFT and no Team Training)
n=36 Participants
Standard NRP curriculum with no team training; simulated resuscitation using low-fidelity simulators
NRP With LFT and Team Training
n=31 Participants
Standard NRP curriculum + team training; simulated resuscitation using low-fidelity simulators
NRP With HFT and Team Training
n=31 Participants
Standard NRP curriculum + team training; simulated resuscitations using high-fidelity simulators
Total
n=98 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Age, Categorical
Between 18 and 65 years
36 Participants
n=5 Participants
31 Participants
n=7 Participants
31 Participants
n=5 Participants
98 Participants
n=4 Participants
Age, Categorical
>=65 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Sex/Gender, Customized
Unknown
36 participants
n=5 Participants
31 participants
n=7 Participants
31 participants
n=5 Participants
98 participants
n=4 Participants
Region of Enrollment
United States
31 participants
n=5 Participants
31 participants
n=7 Participants
31 participants
n=5 Participants
93 participants
n=4 Participants

PRIMARY outcome

Timeframe: During the megacode, which was performed about 1 hour after the training

The teamwork event rate was calculated by summing the number of scored teamwork events (sharing information, inquiry, assertion, teaching/advising, and evaluation of plans) and dividing by the total resuscitation time (in minutes).

Outcome measures

Outcome measures
Measure
Control (NRP Curriculum With LFT and no Team Training)
n=36 Participants
Standard NRP curriculum with no team training; simulated resuscitation using low-fidelity simulators
NRP With LFT and Team Training
n=31 Participants
Standard NRP curriculum + team training; simulated resuscitation using low-fidelity simulators
NRP With HFT and Team Training
n=31 Participants
Standard NRP curriculum + team training; simulated resuscitations using high-fidelity simulators
Teamwork Event Rate
9 teamwork events per minute
Standard Deviation 2.10
10.3 teamwork events per minute
Standard Deviation 3.30
12.8 teamwork events per minute
Standard Deviation 3.40

SECONDARY outcome

Timeframe: During the megacode, which was performed about 1 hour after the training

Workload management percentage was calculated by summing the total time the team demonstrated workload management behavior and dividing by the total resuscitation time.

Outcome measures

Outcome measures
Measure
Control (NRP Curriculum With LFT and no Team Training)
n=36 Participants
Standard NRP curriculum with no team training; simulated resuscitation using low-fidelity simulators
NRP With LFT and Team Training
n=31 Participants
Standard NRP curriculum + team training; simulated resuscitation using low-fidelity simulators
NRP With HFT and Team Training
n=31 Participants
Standard NRP curriculum + team training; simulated resuscitations using high-fidelity simulators
Percentage of Time Spent on Workload Management
89.4 percentage of time
Standard Deviation 15
98.0 percentage of time
Standard Deviation 5.7
98.8 percentage of time
Standard Deviation 5.4

SECONDARY outcome

Timeframe: During the megacode, which was performed about 1 hour after the training

Vigilance percentage was calculated by summing the total time the team demonstrated vigilance behavior and dividing by the total resuscitation time.

Outcome measures

Outcome measures
Measure
Control (NRP Curriculum With LFT and no Team Training)
n=36 Participants
Standard NRP curriculum with no team training; simulated resuscitation using low-fidelity simulators
NRP With LFT and Team Training
n=31 Participants
Standard NRP curriculum + team training; simulated resuscitation using low-fidelity simulators
NRP With HFT and Team Training
n=31 Participants
Standard NRP curriculum + team training; simulated resuscitations using high-fidelity simulators
Percentage of Time Spent on Vigilance
99.6 percentage of time
Standard Deviation 0.8
99.7 percentage of time
Standard Deviation 1.0
99.9 percentage of time
Standard Deviation 0.3

SECONDARY outcome

Timeframe: During the megacode, which was performed about 1 hour after the training

We analyzed 2 measures of NRP quality: performance score and resuscitation duration. The performance score was calculated by averaging the scores (ranging from 0 to 2 - higher values represent a better outcome) for each NRP step (some of which occurred multiple times). Those scores were summed and divided by the total possible score (2 times the number of steps that should have been performed). When a step was not indicated for the specific resuscitation scenario (e.g., meconium aspiration), that step was not scored by the observers and it was not included in the denominator for performance calculation. This produced a measure of performance percentage ranging from 0 percent to 100 percent (higher values represent a better outcome) for each resuscitation.

Outcome measures

Outcome measures
Measure
Control (NRP Curriculum With LFT and no Team Training)
n=36 Participants
Standard NRP curriculum with no team training; simulated resuscitation using low-fidelity simulators
NRP With LFT and Team Training
n=31 Participants
Standard NRP curriculum + team training; simulated resuscitation using low-fidelity simulators
NRP With HFT and Team Training
n=31 Participants
Standard NRP curriculum + team training; simulated resuscitations using high-fidelity simulators
Neonatal Resuscitation Program (NRP) Quality as Assessed by NRP Performance Score
71.5 performance percentage
Standard Deviation 8.3
73.4 performance percentage
Standard Deviation 7.6
72.4 performance percentage
Standard Deviation 9.1

SECONDARY outcome

Timeframe: During the megacode, which was performed about 1 hour after the training

Resuscitation duration is time required to complete the resuscitation. The total duration for each resuscitation was calculated from the start of the instructor's reading of the scenario to the team's statement that the infant should be transferred to the NICU. When any teaching moments occurred during the simulation, the total teaching time was subtracted from the resuscitation duration.

Outcome measures

Outcome measures
Measure
Control (NRP Curriculum With LFT and no Team Training)
n=36 Participants
Standard NRP curriculum with no team training; simulated resuscitation using low-fidelity simulators
NRP With LFT and Team Training
n=31 Participants
Standard NRP curriculum + team training; simulated resuscitation using low-fidelity simulators
NRP With HFT and Team Training
n=31 Participants
Standard NRP curriculum + team training; simulated resuscitations using high-fidelity simulators
Neonatal Resuscitation Program (NRP) Quality as Assessed by Resuscitation Duration
634 seconds
Standard Deviation 259
514 seconds
Standard Deviation 139
443 seconds
Standard Deviation 142

Adverse Events

Control (NRP Curriculum With LFT and no Team Training)

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

NRP With LFT and Team Training

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

NRP With HFT and Team Training

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Dr. Eric Thomas

University of Texas HSC-Houston

Phone: 713-500-7958

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place