Public Defence: Christiane Skåre - Anaesthesiology
Cand.med. Christiane Skåre at Institute of Clinical Medicine will be defending the thesis “Quality improvement in neonatal resuscitation – an educational approach” for the degree of PhD (Philosophiae Doctor).
Trial Lecture – time and place
See Trial Lecture.
- First opponent: Associate Professor Hege Ersdal, Faculty of Health Sciences, University of Stavanger
- Second opponent: Professor Doris Østergaard, Department of Clinical Medicine, University of Copenhagen, Denmark
- Third member and chair of the evaluation committee: Professor Anne Cathrine Staff, Faculty of Medicine, University of Oslo
Chair of the Defence
Professor II Pål Aksel Næss, Faculty of Medicine, University of Oslo
MD Theresa Mariero Olasveengen, Oslo University Hospital
During the first minutes of life, the newborn takes its first breaths and aerates the fluid-filled lungs. This marks the start of the transition adapting to life outside the uterus. Health care providers need knowledge and skills to start neonatal resuscitation if the newborn does not spontaneously breathe after birth.
The aim of this thesis was to develop and determine whether a bundled quality improvement initiative consisting of post-event performance-focused debriefings and high-frequency/short duration training (PPV-Refreshers) improves process of care in neonatal resuscitation.
All newborns receiving positive pressure ventilation (PPV) were prospectively video-filmed, and initial performance data guided the development of educational interventions. The videos were also used in debriefings, focusing on guideline adherence and non-technical skills. The PPV-Refreshers were performed in-situ in the resuscitation bay with a newborn manikin and standard equipment.
Four percent of the live born infants received PPV, but need for advanced resuscitation measures such as chest compressions was rare (0.3%). The videos revealed important gaps in knowledge and skills such as; delays in checking the heart rate and initiation of PPV, unnecessary pauses in ventilation, and sub-optimal teamwork. During the study period, 297 PPV-Refreshers and 52 debriefings were completed with >80% of the providers attending at least one session. We found improvement in adherence to guidelines and quality of care (measured by a validated assessment tool), shorter time to spontaneous respiration, and improved Apgar Score at 5 minutes after implementation of debriefings and PPV-Refreshers.
In conclusion, we were able to identify gaps in knowledge by video recordings, and use these to tailor and implement an educational intervention. We observed improvement in adherence to guidelines and quality of care after the implementation.
Contact the research support staff.