title: Rural hospital preparedness for neonatal resuscitation.
abstract: BACKGROUND
  Neonatal resuscitation is a critical component of perinatal services in all settings.
  
  
  OBJECTIVE
  To systematically describe preparedness of rural hospitals for neonatal resuscitation, and to determine whether delivery volume and level of perinatal care were associated with overall preparedness or its indicators.
  
  
  METHODS
  We developed the 15-point Hospital Neonatal Resuscitation Survey to examine institutional preparedness for neonatal resuscitation in 4 areas: policy and procedure, resuscitation team membership, continuing education, and connections with a wider system of perinatal care. All 58 rural hospitals with perinatal services in 2 upper Midwestern states (North Dakota and Minnesota) were asked to provide information describing preparedness for neonatal resuscitation. Nursing administrators responded to the survey.
  
  
  RESULTS
  A total of 26 hospitals took part. Annual delivery volume ranged from 4 to 958. Preparedness scores ranged from 4 to 12. Hospitals with more than 125 deliveries each year reported significantly higher levels of preparedness than lower volume hospitals (9.50 vs 5.83, P < .001). Overall preparedness was not associated with level of perinatal care. Most rural hospitals did not identify a formal collaborative relationship with a regional level III perinatal center.
  
  
  CONCLUSIONS
  Substantial variation in hospital preparedness for neonatal resuscitation was identified. Preparedness was associated with delivery volume. Lack of collaborative agreements between rural hospitals and level III perinatal centers was pervasive. Additional research into the measurement of hospital preparedness for neonatal resuscitation as a component of quality rural perinatal care is needed to optimize outcomes for rural-born neonates.
authors.affiliation: School of Nursing, University of Alabama at Birmingham, Birmingham, AL 35294, USA. jukkalaa@uab.edu
authors.forename: Angela
authors.initials: A
authors.lastname: Jukkala
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Henly
authors.forename: Linda
authors.initials: L
authors.lastname: Lindeke
mesh_terms: D003625:Data Collection; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D004630:Emergencies; D005260:Female; D006780:Hospitals, Rural / Q000706:statistics & numerical data*; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data*; D008910:Minnesota; D009658:North Dakota; D018743:Perinatal Care; D011247:Pregnancy; D012041:Regional Medical Programs / Q000706:statistics & numerical data*; D012151:Resuscitation / Q000706:statistics & numerical data*; D012424:Rural Population