Impact of Standardized Communication Techniques on Errors during Simulated Neonatal Resuscitation.
OBJECTIVE
Current patterns of communication in high-risk clinical situations, such as resuscitation, are imprecise and prone to error. We hypothesized that the use of standardized communication techniques would decrease the errors committed by resuscitation teams during neonatal resuscitation.


METHODS
In a prospective, single-blinded, matched pairs design with block randomization, 13 subjects performed as a lead resuscitator in two simulated complex neonatal resuscitations. Two nurses assisted each subject during the simulated resuscitation scenarios. In one scenario, the nurses used nonstandard communication; in the other, they used standardized communication techniques. The performance of the subjects was scored to determine errors committed (defined relative to the Neonatal Resuscitation Program algorithm), time to initiation of positive pressure ventilation (PPV), and time to initiation of chest compressions (CC).


RESULTS
In scenarios in which subjects were exposed to standardized communication techniques, there was a trend toward decreased error rate, time to initiation of PPV, and time to initiation of CC. While not statistically significant, there was a 1.7-second improvement in time to initiation of PPV and a 7.9-second improvement in time to initiation of CC.


CONCLUSIONS
Should these improvements in human performance be replicated in the care of real newborn infants, they could improve patient outcomes and enhance patient safety.
Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University, Stanford, Palo Alto, California.
Nicole K
NK
Yamada
Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University, Stanford, Palo Alto, California.
Janene H
JH
Fuerch
Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University, Stanford, Palo Alto, California.
Louis P
LP
Halamek
D000465:Algorithms; D002140:California; D002983:Clinical Competence / Q000592:standards*; D003142:Communication; D019983:Guideline Adherence; D006801:Humans; D007231:Infant, Newborn; D010348:Patient Care Team; D016544:Patient Simulation; D011446:Prospective Studies; D012151:Resuscitation / Q000592:standards*; D016037:Single-Blind Method