Dive in the history of video review in our NICU

Other research from our unit

Provider Perspectives on Recording and Reviewing Neonatal Resuscitation: A Qualitative Study

den Boer MC, Houtlosser M, Foglia EE, Tan R, Engberts DP, Te Pas AB. Benefits of recording and reviewing neonatal resuscitation: the providers' perspective. Arch Dis Child Fetal Neonatal Ed. 2019;104(5):F528-f34.

This qualitative study investigated healthcare provider perspectives on recording and reviewing neonatal resuscitations, interviewing staff from NICUs in the Netherlands and the USA.

Key benefits reported by providers include:

• Powerful learning tool for improving skills, with uses in group reviews and individual feedback.

• Enhanced time awareness during critical moments.

• Improved adherence to established medical guidelines.

• A shift towards less invasive resuscitation practices.

Providers unanimously recommend wider adoption of this practice, highlighting these factors for success:

• Clear communication and education for staff.

• A focus on learning and improvement, not punishment.

Overall, this study demonstrates that recording and reviewing neonatal resuscitations is a transformative approach with the potential to significantly enhance the quality of neonatal care.

The Promise and Ethics of Recording Neonatal Resuscitations

den Boer MC, Houtlosser M, van Zanten HA, Foglia EE, Engberts DP, Te Pas AB. Ethical dilemmas of recording and reviewing neonatal resuscitation. Arch Dis Child Fetal Neonatal Ed. 2018;103(3):F280-F284.

Saving newborns' lives through resuscitation is a critical skill, but ensuring optimal care is complex. While appropriate ventilation is crucial, it can be challenging to deliver, and inadequate support can have severe consequences.

Video and physiological monitoring during resuscitation offer invaluable insights for training, research, and quality improvement. However, this powerful tool raises important ethical dilemmas:

• Conflicting frameworks: Recording procedures involves balancing ethical principles from medicine, research, and data management. Standards for things like consent, privacy, and storage vary.

• Complex questions: When is consent needed? How do we protect privacy? These questions become even more complex when dealing with vulnerable newborns.

The potential benefits are clear, but wider use of this technique requires careful consideration of its ethical implications. Further research must address these dilemmas to ensure responsible implementation, safeguarding both patients and the integrity of this valuable practice.

Neonatal resuscitation gets a boost from video audits!

Root L, van Zanten HA, den Boer MC, Foglia EE, Witlox R, Te Pas AB. Improving Guideline Compliance and Documentation Through Auditing Neonatal Resuscitation. Front Pediatr. 2019;7:294.

This study investigated whether reviewing video recordings of resuscitations could improve adherence to best practices and medical recordkeeping in the Neonatal Intensive Care Unit (NICU). Researchers at Leiden University Medical Center analyzed resuscitation videos from infants born before and after implementing weekly video review sessions.

The results are promising. After video audits became routine, healthcare providers significantly improved their compliance with resuscitation guidelines (63% to 77%). This translated to better care, with providers utilizing appropriate respiratory support, air conditions, and oxygen levels. Importantly, documentation in medical records also saw a dramatic rise in accuracy (39% to 65%).

This study highlights the potential of video review as a valuable tool for improving the quality of neonatal resuscitation. By offering a chance to objectively evaluate past practices, video audits can lead to better adherence to guidelines and more comprehensive medical records. This ultimately translates to improved care for critically ill newborns.

Parents find value in reviewing neonatal resuscitation recordings

den Boer MC, Houtlosser M, Witlox RSGM, et al. Reviewing recordings of neonatal resuscitation with parents. Arch Dis Child Fetal Neonatal Ed. 2021;106(4):346-351.

In a qualitative study at Leiden University Medical Center's NICU, parents were offered the opportunity to review the resuscitation of their premature infants with the help of a healthcare provider. The results were remarkably positive:

• Understanding through images: Parents reported that reviewing recordings offered a crucial way to comprehend the complex start of their child's life and manage any associated trauma.

• Increased appreciation: This process often led to deeper appreciation for the baby, their partner, and the lifesaving efforts of the medical team.

• Finding comfort: Parents found particular comfort in having screenshots or copies of the recordings, especially after a child's passing.

This study challenges preconceptions: Sharing resuscitation recordings with parents appears to be a valuable and beneficial tool. Researchers believe these findings may reshape how we approach communication and support for families in the NICU, providing an avenue for understanding and even healing.

Neonatal Resuscitation: Gaps Between Guidelines and Practice Revealed

Schilleman K, Siew ML, Lopriore E, Morley CJ, Walther FJ, Te Pas AB. Auditing resuscitation of preterm infants at birth by recording video and physiological parameters. Resuscitation. 2012;83(9):1135-9.

Preterm infants face critical moments during delivery, but does the care they receive fully align with established guidelines? This study investigated how closely providers follow neonatal resuscitation guidelines, combining video recordings and physiological monitoring to reveal some striking findings.

Key Findings:

• Frequent deviations: In 74% of cases, at least one respiratory intervention didn't align with guidelines. In 29% of cases, other critical practices like heat loss prevention weren't fully followed.

• Unused information: Despite real-time data on respiratory function, providers largely ignored this valuable information during resuscitation.

• The breathing dilemma: It's surprisingly difficult for providers to accurately assess if a preterm infant is breathing spontaneously, leading to potential delays or unnecessary interventions.

Implications: This study highlights potential areas for improvement in neonatal resuscitation. It emphasizes the need for strategies to better integrate guidelines into practice, utilize physiological data effectively, and improve assessment techniques for neonatal breathing. By addressing these challenges, we can ensure the best possible care for these vulnerable infants.

Seeing is Believing, But Measuring is Knowing: The Rise of Objective Monitoring in Neonatal Resuscitation

van Vonderen JJ, van Zanten HA, Schilleman K, Hooper SB, Kitchen MJ, Witlox RS, et al. Cardiorespiratory Monitoring during Neonatal Resuscitation for Direct Feedback and Audit. Front Pediatr. 2016;4:38.

Newborn resuscitation is a lifesaving procedure, and proper ventilation is key. The challenge? Traditionally, assessing a baby's condition and treatment effectiveness relied on subjective observations like heart rate and color.

This review highlights the growing role of objective monitoring tools in neonatal resuscitation. Technologies like ECG, pulse oximetry, capnography, and respiratory function monitors provide crucial data that goes beyond the limitations of visual assessment.

Here's the exciting part: this information can be used live to guide resuscitation efforts and also be reviewed later for training and quality improvement. While further research is needed to confirm its impact, objective monitoring has the potential to revolutionize how we care for newborns during these critical moments.