Interdisciplinary Perspectives on Neonatal Intensive Care Resuscitation with Debriefing Initiatives
Avril M. Laurendine, Cheryl V. McCarthy, Lynette Farmer, and Margaret A. Gettis
In an effort to improve the effectiveness of an interprofessional team in future resuscitation events in a neonatal intensive care unit (NICU) in the southeastern United States, a study was conducted to assess staff comfort with code blue events and to identify areas of need and areas of strength in code performance. Computer-based, anonymous surveys were completed by registered nurses (RNs) (n = 60), respiratory therapists (RTs) (n = 15), neonatologists (n = 4), neonatal nurse practitioners (NPs) (n = 3), and a physician assistant (PA) (n = 1). Questions were role-specific; thus, two different surveys were used, one for RNs and RTs, and one for neonatologists, NPs, and PA. The neonatologists, NPs, and PA self-reported the need for practice running the defibrillator and believed poor team organization was a factor in codes that had gone poorly in the past. RNs expressed discomfort using the defibrillator and drawing up resuscitation medications. The majority of respondents believed multidisciplinary code-based simulations could positively impact code outcomes and supported post-code debriefings. Staff saw code blue resuscitation training as important in keeping skills and knowledge current. Code organization, clear communication, and application of technical code skills were recognized as areas that needed improvement. Data were used to inform the implementation of a resuscitation debriefing program and targeted staff trainings. Since implementation, code debriefings and targeted trainings have been beneficial to staff.