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Neonatal Resuscitation Program Rolling Refresher: Maintaining Chest Compression Proficiency Through the Use of Simulation-Based Education

Cepeda Brito, Jose R. MD; Hughes, Patrick G. DO; Firestone, Kimberly S. BS, RRT; Ortiz Figueroa, Fabiana MD; Johnson, Karan MSN, RN, RRT, NPS, CPFT; Ruthenburg, Terra RNC-NIC, MSN; McKinney, Robyn BSN, RN; Gothard, M. David MS; Ahmed, Rami DO, MHPE

Section Editor(s): Samra, Haifa A.

doi: 10.1097/ANC.0000000000000384
Professional Growth and Development

Background: Structured training courses have shown to improve patient outcomes; however, guidelines are inconsistently applied in up to 50% of all neonatal resuscitations. This is partly due to the fact that psychomotor skills needed for resuscitation decay within 6 months to a year from the completion of a certification course. Currently, there are no recommendations on how often refresher training should occur to prevent skill decay.

Purpose: Improve provider proficiency and confidence in the performance of neonatal resuscitation with a focus on chest compression effectiveness.

Methods: The study recruited neonatal intensive care unit providers (n = 25). A simulation-based Neonatal Resuscitation Program (NRP) curriculum was developed and executed. Training sessions were delivered utilizing in situ simulations at varying time intervals. Pre- and postconfidence surveys and practicum skill scores were collected and evaluated by a content expert. Categorical data were summarized by frequency and percentage and tested for distributional equality via Pearson chi-square tests or Fisher exact tests depending on cell sample size distribution. All statistical tests were 2-sided with P < .05 considered statistically significant.

Results: Provider overall confidence and rate of chest compressions improved; however, there was no statistically significant difference between groups. Rolling refresher training at varied time intervals did not demonstrate statistically significant differences in chest compression quality among NRP providers.

Implications for Practice: Rolling refresher training more frequently than every 6 months may not provide added benefit to NRP providers.

Implications for Research: Additional research is needed to determine optimal refresher training frequency to prevent skill decay.

Summa Health System, Akron, Ohio (Drs Cepeda Brito, Hughes, Figueroa, and Ahmed); Akron Children's Hospital, Akron, Ohio (Mss Firestone, Johnson, Ruthenburg, McKinney); and BIOSTATS, Data Analysis for Clinical Research Studies (Dr Gothard).

Correspondence: Jose R. Cepeda Brito, MD, Medical Simulation Fellow, Summa Health System, ORCID: 0000-0001-6533-2012, 9911 E 21st St. N, Apt 703, Wichita, KS 67206 (

This study was conducted at Akron Children's Hospital NICU at Summa.

The authors have no conflicts of interest to declare.

© 2017 by The National Association of Neonatal Nurses