Simulation-based retention of basic neonatal life support in parents

BACKGROUND: Infants who are discharged from the NICU (Neonatal Intensive Care Unit) are at higher risk for cardiopulmonary arrest and need for CPR. Parents of such neonates are routinely given basic CPR training before they are discharged from the hospital. This training is usually basic and short. CPR simulation training is a critical tool for appraisal of knowledge and skill for the participants. Our study aims to show that a CPR simulation will be effective in improving the CPR knowledge and skills of parents as well and should be implemented as a standard for routine CPR training in NICUs.

METHODS AND RESULTS: We conducted a prospective non-blinded randomized interventional trial that took place in Shaare Zedek Medical Center in Jerusalem. The study population included parents of neonates in the NICU that had the routine CPR training in the hospital that includes a short 30-minute lecture from a NICU nurse and a demonstration of CPR. They were randomly assigned to one of two groups, the study group, and the control group. The parents that were in the study group had a training simulation with one of the investigators a few days after the initial training followed by an assessment simulation a few days later, those who were assigned to the control group had only one assessment simulation after the initial training to assess their CPR knowledge and skills. A total of 50 parents agreed to participate in the study. When comparing the final simulation scores between the study group and the control group there was a statistically significant difference in all parameters with the exception of the queen’s diagnostic score given by the second observer. All of the parents improved at least one of their scores with the majority improving at least 50% of them. The average improvement of the AHA score was 2.25 points. Only 2 of the parents did not improve their AHA score given by the second observer and all of the parents improved their AHA score given by the first observer.

CONCLUSIONS: This study showed that adding a CPR simulation in the training of parents of neonates that being discharged from the NICU can significantly improve their CPR performance. All of the parents that had an additional simulation improved their performance in the second simulation. Further, larger scale studies are necessary to identify the correct use of simulation in parental BLS training.