Single-Day vs Longitudinal NRP Training for Neonatal Resuscitation Skills

Recruiting at 6 trial locations

Overseen By Audrey Larone Juneau, M.Sc

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Ahmed Moussa

Disqualifiers: Completed NRP training

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 10

250 Participants Needed

Trial Summary

What is the purpose of this trial?

This trial is testing a new way to retrain nurses in neonatal resuscitation. It targets nurses in Canadian NICUs who face challenges like budget cuts and high staff turnover. The new training method uses various tools like books, online exams, and practice stations to help nurses stay skilled in emergency newborn care.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of this treatment?

Research shows that the Neonatal Resuscitation Program (NRP) is effective in improving both knowledge and practical skills in participants, including pediatric residents and nurses, which helps in reducing complications during birth. The program has been shown to enhance comfort levels in providing neonatal resuscitation and improve skill performance, although maintaining these skills over time may require additional strategies. ^{1 2 3 4 5}

Is Neonatal Resuscitation Program (NRP) training safe for participants?

The Neonatal Resuscitation Program (NRP) is widely used to train healthcare professionals in managing newborns, and it is considered safe as it focuses on education and skill development rather than medical treatment. ^{1 2 3 6 7}

How does the Neonatal Resuscitation Program Training differ from other treatments for neonatal resuscitation skills?

The Neonatal Resuscitation Program (NRP) Training is unique because it offers two different approaches: a single-day intensive course and a longitudinal training spread over time, allowing for flexibility in learning and skill retention. This contrasts with other treatments that may not offer such varied training schedules. ^{8 9 10 11 12}

Eligibility Criteria

This trial is for newly recruited registered nurses working in level 2 and 3 perinatal centers who have joined within the last three months. Nurses who have previously completed NRP training are not eligible to participate.

Inclusion Criteria

I am a new neonatal or delivery room nurse at a level 2 or 3 perinatal center.

Exclusion Criteria

I am a registered nurse who has completed NRP training.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Single-day NRP Training

Participants undergo a single-day NRP training course, which takes 8 hours to complete

1 day

1 visit (in-person)

Longitudinal NRP Training

Participants undergo a longitudinal NRP training course consisting of nine 30-minute modules taught every 6-8 weeks over a year

1 year

9 visits (in-person)

Follow-up

Participants are monitored for knowledge retention and cost-efficiency of the training methods

1 year

Treatment Details

Interventions

• Longitudinal NRP Training
• Single-day NRP Training

Trial Overview The study is examining two methods of Neonatal Resuscitation Program (NRP) training: a traditional single-day session versus a new longitudinal approach. The goal is to determine which method better maintains nurses' resuscitation skills, considering educational outcomes and financial implications.

Participant Groups

Group I: Single-day NRP training Experimental Treatment 1 Intervention

This group will follow the single-day NRP training course that is currently the standard. It usually takes 8 hours to complete this training course and the nurses are released from their clinical duty to attend the training course.

Group II: Longitudinal one year NRP Training Experimental Treatment 1 Intervention

This group will follow the longitudinal NRP training course. The longitudinal NRP training course will consist of nine 30-minute modules that will be taught every 6-8 weeks over a period of one year. The nurses will attend the different modules of the training course at their work place and during their work shift so they will have to be released from their clinical duty only 30 minutes at a time.

Who Is Running the Clinical Trial?

Ahmed Moussa

Lead Sponsor

Trials

2

Recruited

300+

Findings from Research

Iraqi residents who participated in the Neonatal Resuscitation Program (NRP) course showed a significant increase in knowledge, with correct answers rising from 52% before the course to 85% after (p < 0.001).

Despite the knowledge gain, only 14% of participants passed the practical Mega code simulation exam, indicating that while theoretical understanding improved, practical performance in clinical simulations remains an area needing further development.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Knowledge and practical performance gained by Iraqi residents after participation to a neonatal resuscitation program course. Jabir, MM., Doglioni, N., Fadhil, T., et al.[2019]

NRP training significantly improves the resuscitation skills and knowledge of pediatric residents, with those who attended the course scoring higher on assessments compared to those who did not.

Senior residents and those trained in NRP demonstrated better performance, highlighting the importance of early training in neonatal resuscitation to enhance the quality of care for newborns.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Resuscitation skills of pediatric residents and effects of Neonatal Resuscitation Program training. Gunay, I., Agin, H., Devrim, I., et al.[2016]

The enhanced format of the Neonatal Resuscitation Program (NRP) course significantly improved new clinicians' comfort levels in performing neonatal resuscitation, as indicated by post-intervention surveys.

This pilot project involved a convenience sample of nurses, respiratory therapists, and physicians, and emphasized hands-on practice, which was crucial for increasing participants' confidence in using resuscitation equipment and skills.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Enhanced Neonatal Resuscitation Provider Course for Novice Learners. Copple, S.[2022]

A one-day neonatal resuscitation education program significantly improved both knowledge and skill performance among 190 nurses, demonstrating its efficacy in training perinatal staff.

While knowledge was retained at six months, skill performance declined, indicating a need for ongoing training strategies to maintain practical skills in neonatal resuscitation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The provision and evaluation of a neonatal resuscitation program. Dunn, S., Niday, P., Watters, NE., et al.[2022]

A study involving 42 pediatric residents showed that knowledge retention from the Neonatal Resuscitation Program (NRP) decreased significantly after 6 months and 1 year, indicating a need for regular refresher courses.

Intubation skills also declined over time, with performance worsening after 1 year, suggesting that annual training could help maintain proficiency in critical neonatal resuscitation techniques.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Proficiency and knowledge gained and retained by pediatric residents after neonatal resuscitation course. Duran, R., Aladağ, N., Vatansever, U., et al.[2022]

In a study of 50 neonatal intubation attempts, 73% were successful, but the performance varied significantly among different trained individuals, with respiratory therapists achieving a 100% success rate compared to 63% for pediatric residents and 69% for NICU fellows.

The average time for successful intubation was 51 seconds, which exceeds the recommended time by NRP and American Heart Association guidelines, indicating a need for improved training methods in neonatal intubation for pediatric residents and fellows.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Failure of pediatric and neonatal trainees to meet Canadian Neonatal Resuscitation Program standards for neonatal intubation. Bismilla, Z., Finan, E., McNamara, PJ., et al.[2022]

The Neonatal Resuscitation Program (NRP) 8th edition, released in June 2021, incorporates the latest evidence-based guidelines from the American Academy of Pediatrics and the American Heart Association, ensuring that healthcare professionals are trained with the most current practices for assisting newborns at birth.

While there were no major changes in practice from previous editions, the NRP 8th edition reflects new, higher-quality evidence that supports existing recommendations, emphasizing patient safety and educational efficiency in neonatal resuscitation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The NRP 8th Edition: Innovation in Education. Zaichkin, J., Kamath-Rayne, BD., Weiner, G.[2023]

The authors propose a new standardized naming system for NMR experiments to address the lack of consistency in naming, which is crucial for organizing and understanding the vast array of NMR data.

This new system is based on a formal 'NMR experiment protocol' model described in the Universal Modelling Language (UML), aiming to enhance clarity and communication in the field of NMR spectroscopy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A nomenclature and data model to describe NMR experiments. Fogh, RH., Vranken, WF., Boucher, W., et al.[2022]

The study demonstrates an efficient method for implementing RN(n)(nu) symmetry-based pulse schemes in high magic-angle spinning frequencies, which are crucial for enhancing nuclear spin interactions in biological solid-state NMR.

By optimizing the phase-modulation profile of 180-degree RF pulses, the researchers achieved effective magnetization transfer for 13C-13C dipolar recoupling and chemical shift correlation, indicating improved performance in NMR investigations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Numerical design of RN(n)(nu) symmetry-based RF pulse schemes for recoupling and decoupling of nuclear spin interactions at high MAS frequencies. Herbst, C., Herbst, J., Leppert, J., et al.[2021]

Using 15N labeling can help determine the structure of larger proteins (over 10 kDa) by improving resonance clarity in NMR spectroscopy.

The new method based on 15N single-quantum coherence offers better resolution compared to the traditional heteronuclear multiple-quantum coherence, making it a more effective approach for studying protein structures.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Improved resolution in 1H-detected 1H-15N correlation experiments. Norwood, TJ., Boyd, J., Campbell, ID.[2019]

In nitrogen-14 NQR experiments, the composite pulse (45)0(95)180(164)0 produced the best results for induction and echo signals, indicating its superior efficacy compared to other tested pulses.

The study utilized various published composite pulses, providing a comparative analysis of their performance, which highlights the importance of pulse selection in optimizing NQR measurements.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Comparative experimental analysis of composite pulses in 14N NQR. Mikhaltsevitch, VT., Rudakov, TN., Flexman, JH., et al.[2019]

In a study involving 143 healthcare providers, it was found that shorter rest periods during 30 minutes of chest compressions (CC) led to a significant decline in the quality of compressions, particularly in depth, highlighting the importance of adequate rest for maintaining CPR effectiveness.

The research suggests that a 6-minute rest period after every 2 minutes of CC is crucial, indicating that at least four personnel are needed to minimize rescuer fatigue and sustain high-quality CPR over the full duration.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The optimal number of personnel for good quality of chest compressions: A prospective randomized parallel manikin trial. Yamanaka, S., Huh, JY., Nishiyama, K., et al.[2018]

References

1. Norway pubmed.ncbi.nlm.nih.gov

Knowledge and practical performance gained by Iraqi residents after participation to a neonatal resuscitation program course. [2019]

2. Australia pubmed.ncbi.nlm.nih.gov

Resuscitation skills of pediatric residents and effects of Neonatal Resuscitation Program training. [2016]

3. United States pubmed.ncbi.nlm.nih.gov

Enhanced Neonatal Resuscitation Provider Course for Novice Learners. [2022]

4. United States pubmed.ncbi.nlm.nih.gov

The provision and evaluation of a neonatal resuscitation program. [2022]

5. Australia pubmed.ncbi.nlm.nih.gov

Proficiency and knowledge gained and retained by pediatric residents after neonatal resuscitation course. [2022]

6. United States pubmed.ncbi.nlm.nih.gov

Failure of pediatric and neonatal trainees to meet Canadian Neonatal Resuscitation Program standards for neonatal intubation. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

The NRP 8th Edition: Innovation in Education. [2023]

8. Netherlands pubmed.ncbi.nlm.nih.gov

A nomenclature and data model to describe NMR experiments. [2022]

9. Netherlands pubmed.ncbi.nlm.nih.gov

Numerical design of RN(n)(nu) symmetry-based RF pulse schemes for recoupling and decoupling of nuclear spin interactions at high MAS frequencies. [2021]

10. England pubmed.ncbi.nlm.nih.gov

Improved resolution in 1H-detected 1H-15N correlation experiments. [2019]

11. Netherlands pubmed.ncbi.nlm.nih.gov

Comparative experimental analysis of composite pulses in 14N NQR. [2019]

12. United States pubmed.ncbi.nlm.nih.gov

The optimal number of personnel for good quality of chest compressions: A prospective randomized parallel manikin trial. [2018]