Prospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Pediatr. Feb 8, 2017; 6(1): 69-80
Published online Feb 8, 2017. doi: 10.5409/wjcp.v6.i1.69
Video recording of neonatal resuscitation: A feasibility study to inform widespread adoption
Sandesh Shivananda, Jennifer Twiss, Enas el-Gouhary, Salhab el-Helou, Connie Williams, Prashanth Murthy, Gautham Suresh
Sandesh Shivananda, Jennifer Twiss, Enas el-Gouhary, Salhab el-Helou, Connie Williams, Prashanth Murthy, Department of Pediatrics, McMaster University, Hamilton, ON L8N 3Z5, Canada
Gautham Suresh, Pediatrics-Newborn, Baylor College of Medicine, Houston, TX 77030, United States
Author contributions: Shivananda S coordinated and supervised data collection, carried out the initial analysis, and drafted the initial manuscript; Twiss J, el-Gouhary E, el-Helou S, Williams C and Murthy P took part in designing and data collection; Suresh G reviewed and revised the manuscript; Shivananda S conceptualized and designed the study, implemented the protocol, and reviewed the manuscript; all authors approved the final manuscript as submitted.
Supported by the Centre for Healthcare Optimization Research and Delivery (CHORD) at Hamilton Health Sciences with an aim of facilitating knowledge transfer initiatives from health care and supportive teams.
Institutional review board statement: The study was reviewed and approved by the institutional review boards of McMaster University and Faculty of Health Sciences Hamilton and Hamilton Health Sciences Quality and patient safety committee.
Clinical trial registration statement: This study was planned to assess feasibility (pilot or proof of concept) of wide scale adoption and study of video recording of neonatal resuscitation. We didn’t register this feasibility study in clinical trial registry.
Informed consent statement: A waiver of consent was obtained from ethics review board for this study.
Conflict-of-interest statement: The authors of this manuscript having no conflicts of interest to disclose.
Data sharing statement: All data supporting the study are provided in full in the results section of the manuscript, whereas video recording clips were deleted after review to ensure subject’s privacy and confidentiality. There is no additional data available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Sandesh Shivananda, MD, MSc, FRCPC, Associate Professor, Department of Pediatrics, McMaster University, 1200 Main St. West, Hamilton, ON L8N 3Z5, Canada. sandesh@mcmaster.ca
Telephone: +1-905-5212100-73490 Fax: +1-905-5215007
Received: June 25, 2016
Peer-review started: June 28, 2016
First decision: September 5, 2016
Revised: October 12, 2016
Accepted: November 16, 2016
Article in press: November 17, 2016
Published online: February 8, 2017
Processing time: 220 Days and 14.9 Hours
Abstract
AIM

To determine the feasibility of introducing video recording (VR) of neonatal resuscitation (NR) in a perinatal centre.

METHODS

This was a prospective cohort quality improvement study on preterm infants and their caregivers. Based on evidence and experience of other centers using VR intervention, a contextually relevant implementation and evaluation strategy was designed in the planning phase. The components of intervention were pre-resuscitation team huddle, VR of NR and video debriefing (VD), all occurring on the same day. Various domains of feasibility and sustainability as well as feasibility criteria were predefined. Data for analysis was collected using quantitative and qualitative methods.

RESULTS

Seventy-one caregivers participated in VD of 14 NRs facilitated by six trained instructors. Ninety-one percent of caregivers perceived enhanced learning and patient safety and, 48 issues were identified related to policy, caregiver roles, and latent safety threats. Ninety percent of caregivers expressed their willingness to participate in VD activity and supported the idea of integrating it into a resuscitation team routine. Eighty-three percent and 50% of instructors expressed satisfaction with video review software and quality of audio VR. No issues about maintenance of infant or caregivers’ confidentiality and erasure of videos were reported. Criteria for feasibility were met (refusal rate of < 10%, VR performed on > 50% of occasions, and < 20% caregivers’ perceiving a negative impact on team performance). Necessary adaptations to enhance sustainability were identified.

CONCLUSION

VR of NR as a standard of care quality assurance activity to enhance caregivers’ learning and create opportunities that improve patient safety is feasible. Despite its complexity with inherent challenges in implementation, the intervention was acceptable, implementable, and potentially sustainable with adaptations.

Keywords: Video recording; Neonatal resuscitation; Delivery room; Feasibility; Perinatal centre

Core tip: Despite proven benefits video recording (VR) of neonatal resuscitation (NR) is not adopted by all perinatal centres. Major reasons include challenges in operationalization and sustainability. Understanding the enablers and mitigation strategies is crucial on making a decision on widespread adoption of VR of NR by hospitals. We conducted a feasibility analysis of introducing VR of NR in the delivery room. It was introduced as a standard of care quality assurance activity to enhance caregiver learning and address system issues that compromise patient safety. Our study results indicate that VR of NR was effective, acceptable, implementable, and potentially sustainable with adaptations.