Assessment of neonatal resuscitation performance using video recording in a perinatal centre.
OBJECTIVE
To assess the quality of neonatal resuscitation using video recordings in a perinatal centre.


METHODS
Video recording was performed during high-risk deliveries between August 2007 and January 2008. Video recordings of neonatal resuscitations were assessed using a scoring tool previously used to assess resuscitation performance. Qualitative assessments and observations of team function and technical aspects of management were also recorded. Apgar scores documented in the Medical History and those derived from the video record were compared.


RESULTS
Twenty video recordings of neonatal resuscitations were assessed. Of the assessed domains; invasive ventilation and administration of surfactant were performed best with median scores of 100%. Performed least well were preparation and initial steps as well as the assessment and communication of heart rate (HR); 69% and 75%, respectively. Apgar scores were overestimated by a median value of 2 points at both 1 and 5 min (P < 0.001). Errors during resuscitation included inadequate oropharyngeal suction, aggressive stimulation, poor communication of heart rate and inadequate non-invasive ventilation. Failure to detect deterioration was also observed.


CONCLUSIONS
Video recording identified strengths and weaknesses in the performance of neonatal resuscitation and can facilitate targeted education and quality assurance programmes.
Gelbart
Ben
B
Mercy Hospital for Women, 163 Studley Road Heidelberg 3084, Victoria, Australia. ben.gelbart@rch.org.au
Hiscock
Richard
R
Barfield
Charles
C
D001034:Apgar Score; D002983:Clinical Competence / Q000592:standards; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal; D008297:Male; D018743:Perinatal Care; D011247:Pregnancy; D011248:Pregnancy Complications; D011785:Quality Assurance, Health Care; D012151:Resuscitation / Q000592:standards*; D013647:Task Performance and Analysis; D014741:Video Recording