Longitudinal Telesimulation Program and Rural Clinicians' Neonatal Resuscitation Performance.

Abstract

Telesimulation (TS) addresses barriers to delivering simulation training in rural environments. We implemented a longitudinal TS program, Maine Ongoing Outreach Simulation Education (MOOSE), across 5 hospitals. We aimed to improve team adherence to the Neonatal Resuscitation Program (NRP) and assess the impact of team composition and training intervals. Teams at 5 hospitals participated in monthly TS. TS recordings were assessed for adherence to NRP. NRP adherence was regressed against the number of TS in a linear regression model. NRP adherence was also regressed against team composition variables to determine how the experience and training of nurses, physicians, and respiratory therapists impacted performance. Hospitals participated in a total of 6, 7, 8, 10, and 18 sessions reaching 121 unique clinicians, with some participating more than once. On average, NRP score increased 1.3 percentage points with each training. Significant improvements were noted in cardiac compressions and positive pressure ventilation. NRP score was associated with the maximum number of TS sessions completed by team members, the average number of TS sessions completed by team members, and training sessions completed by the physician. Expanding an in situ longitudinal program showed improvement in team adherence to NRP across 5 hospitals. Each additional training for individual members improved team performance. Longitudinal in situ TS is a feasible model to improve interprofessional neonatal resuscitation performance and enhance neonatal emergency readiness.