title: Testing of midwife neonatal resuscitation skills with a simulator manikin in a low-risk delivery unit.
abstract: BACKGROUND
  Expertise in neonatal resuscitation is essential for personnel involved in the care of newborns. In this observational cohort study the skills of 52 midwives in a simulated scenario were assessed.
  
  
  METHODS
  A total of 52 midwives in a low-risk unit and five specialist nurses in a high-risk unit were tested to establish their competence in newborn resuscitation. The 52 midwives were divided into groups 1 (n = 39; no pretest training) and 2 (n = 13; 1 day training prior to study). The video-recorded test scenario was a newborn with asphyxia. Thirty items were graded by a neonatologist and nursing team in real time. Using the Angoff method, a pass score was 18.71 for skills that were graded 0 or 1.
  
  
  RESULTS
  The average score of specialist nurses was 26 (range, 23-29). A total of 49% of midwives in group 1 and 92% in group 2 passed the test. The average score was 17.7 (range, 9-25) in group 1 and 21.9 (range, 17-27) in group 2. A total of 27% and 77% of midwives in groups 1 and 2, respectively, carried out ventilation at a frequency as per the algorithm. Mask leakage was higher in group 1 (44%) versus group 2 (23%). Five and three midwives in groups 1 and 2, respectively, overexpanded the lungs.
  
  
  CONCLUSIONS
  Many midwives had imperfect resuscitation skills. A 1 day course improved such skills. The standard scenario is an objective and useful performance marker in assessing and documenting improvements in competence in delivery room resuscitation.
authors: Children's Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland. liisa.rovamo@hus.fi
authors: Liisa M
authors: LM
authors: Rovamo
authors: Minna-Maria
authors: MM
authors: Mattila
authors: Sture
authors: S
authors: Andersson
authors: Per H
authors: PH
authors: Rosenberg
mesh_terms: D003696:Delivery Rooms; D004509:Education, Nursing, Continuing / Q000379:methods*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008348:Manikins; D008880:Midwifery / Q000193:education*; D057184:Practice Patterns, Nurses'; D011247:Pregnancy; D012151:Resuscitation / Q000193:education* / Q000451:nursing
keywords: midwife; newborn resuscitation; simulation; skill test; ventilation