This project addresses performance gaps in neonatal resuscitation, focusing on the initial steps of care for newborns immediately after birth. Despite adherence to the Neonatal Resuscitation Program (NRP) guidelines, inconsistencies in provider performance and deviations from protocol remain a major challenge, potentially leading to preventable neonatal asphyxia, hypothermia, and delayed ventilation support. A previous prospective observational study conducted at Ramathibodi Hospital from Febr
Conditions
Interventions
This group includes all eligible neonatal resuscitation cases observed before implementation of the quality improvement interventions (Plan phase). Data will be collected prospectively from video and
Health Services Research,Health Services Research
Pre-intervention ,Post-intervention
Sponsors
Mahidol University
Eligibility
Sex/Gender
All
Age
23 Weeks to 42 Weeks
Inclusion criteria
Inclusion criteria: In this study includes two participant groups: (1) newborn infants who undergo neonatal resuscitation and (2) healthcare providers involved in neonatal resuscitation 1. Infants with gestational age estimated by obstetric assessment between 23 and 42 weeks. 2. Infants who undergo neonatal resuscitation in the delivery room or operating theater of the Main Building , Ramathibodi Hospital, performed by a multidisciplinary team following the standard Neonatal Resuscitation Program (NRP) protocol. 3. Written parental or guardian consent obtained according to institutional research regulations. 4. Healthcare providers participating in neontatal resuscitation who provide informed consent to participate in the study
Exclusion criteria
Exclusion criteria: 1. Infants with lethal congenital anomalies diagnosed prenatally that are incompatible with life despite full medical intervention (e.g., anencephaly, bilateral renal agenesis, thanatophoric dysplasia, trisomy 13, or trisomy 18). 2. Infants with major congenital anomalies that significantly affect viability or interfere with standard neonatal resuscitation procedures. 3. Infants with known chromosomal abnormalities diagnosed prenatally. 4. Cases in which parental consent is unobtainable or refused. 5. Newborns resuscitated by medical personnel who decline participation in the research project
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Completion of initial steps of resuscitation Every 2 months after intervention implementation. Proportion of correctly completed initial steps (warmth, positioning, drying, stimulation, suctioning if needed) from video and record review.,Neonatal Resuscitation Adherence Score Every 2 months after intervention implementation. Total adherence score derived from the Neonatal Resuscitation Adherence Score Sheet, assessing correctness and completeness across 13 NRP domains based on video review. | — |
Secondary
| Measure | Time frame |
|---|---|
| Timely initiation of PPV within 1 minute of birth Every 2 months after intervention implementation. Proportion of infants receiving PPV within 60 s of birth when indicated, from time-stamped video and records.,Correct PPV technique Every 2 months after intervention implementation. Proportion of PPV with correct technique (seal, hand position, rate) from video review.,Team performance Every 2 months after intervention implementation. Neonatal Resuscitation Team Performance Score | — |
Countries
Thailand
Contacts
Public ContactNutnaree Rattanapornwong
Mahidol University
Outcome results
None listed