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Multi-site outreach simulation education to improve premature infant admission temperatures

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Multi-site outreach simulation education to improve premature infant admission temperatures

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Multi-site outreach simulation education to improve premature infant admission temperatures

  1. 1. ALERT Presentation: Multisite outreach simulation education to improve premature infant admission temperatures Bobbi J. Byrne MD, Alana Barbato MD Indiana University School of Medicine INSPIRE @ IMSH 2017 – Orlando, FL, USA International Network for Simulation-based Pediatric Innovation, Research and Education
  2. 2. • •Neonatal hypothermia • –associated with higher mortality and morbidity • –thermal control following delivery is an essential part of neonatal care • –relationship between admission temperature and adverse neonatal outcomes is U-shaped • –lowest rates of adverse outcomes are associated with admission temperatures between 36.5C and 37.2C • –(Lyu Y, et al, 2015) International Network for Simulation-based Pediatric Innovation, Research and Education Background
  3. 3. • •Reducing delivery room hypothermia in preterm infants • •AAP NRP recommendations • –Increase delivery room temperature • –Appropriate use of radiant warmer • –Placement of infant hat immediately • –Placement into plastic bag/wrap immediately • –Use of chemically activated warming mattresses International Network for Simulation-based Pediatric Innovation, Research and Education Background
  4. 4. • •Single center pilot study, 2015-2017 • •Indiana University Neonatal Outreach Simulation (NOS) Program • •Developed in 2010-11 • •Provide simulation education from the AHC to community hospitals throughout the state of Indiana • Funding: internal, IUHealth Values Grant, MOD, • •Over 170 programs – half or full day • •51 different community hospitals • •>3800 learners • •Since July 2011 International Network for Simulation-based Pediatric Innovation, Research and Education Background
  5. 5. • •Pilot Study three phases • 1. Initial simulation education • 2. Follow up visit to assess retention and “trickle down”/dissemination effect 6-18 months after initial education • 3. Patient chart review for each community hospital to document clinical changes in premature infant admit temps prior to and after education • •5 year period prior to ANY premature infant simulation education • •18 months after the simulation education International Network for Simulation-based Pediatric Innovation, Research and Education Background
  6. 6. • Population: Community hospital newborn resuscitation teams • Intervention: Several different groups contemplated based on results of pilot work • Control/Comparison: As above • Outcome(s): Improve premature infant admission temperatures in newborns born in community hospitals International Network for Simulation-based Pediatric Innovation, Research and Education PICO / Research Question
  7. 7. International Network for Simulation-based Pediatric Innovation, Research and Education Approach / Design •Sites that used the checklist in the second scenario of year one or upon our return in year two performed better –Added to the analysis in year two •Sites that developed a “Premie Pack” performed better –Not added to analysis but recommended in debriefing phase, example provided
  8. 8. International Network for Simulation-based Pediatric Innovation, Research and Education Approach / Design •During the study period, delayed cord clamping for premature infants was implemented as a recommendation by the AAP NRP. •We implemented this into our education/debriefing in year two •Among other benefits, there is a decreased risk in necrotizing enterocolitis (NEC), decrease in number of transfusions, decrease in intraventricluar hemorrhage (IVH)
  9. 9. International Network for Simulation-based Pediatric Innovation, Research and Education Approach / Design •Created a video to demonstrate the concomitant use of thermoregulation maneuvers (placement into plastic wrap) and delayed cord clamping •Provided behavioral skills to allow communication with OB promoting this technique
  10. 10. • ALERT Presentation: 1/28/17 • Grant Proposal (if applicable): Summer 2017 • IRB Submission: Fall 2017 • Recruitment / Data Collection: 2018 • Data Analysis 2018-2019 • Abstract Presentation: 2019 • Manuscript(s) Preparation: 2018, 2019 International Network for Simulation-based Pediatric Innovation, Research and Education Timeline
  11. 11. 1. Define the interventions based on ability of outreach programs to interact with community hospitals. 2. Discuss possible funding mechanisms. 3. Recruit sites to participate International Network for Simulation-based Pediatric Innovation, Research and Education 3 questions to improve study
  12. 12. • At INSPIRE @ IMSH 2017: Obtain feedback to refine, strengthen and solidify study design as well as identify potential mentors/collaborators • In 2 months: complete grant application (K23) International Network for Simulation-based Pediatric Innovation, Research and Education Goals to accomplish
  13. 13. Name: Bobbi Byrne Institution: Indiana University School of Medicine E-mail: bjbyrne@iu.edu International Network for Simulation-based Pediatric Innovation, Research and Education Contact Information

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