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An Advanced Neonatal Resuscitation Educational Program in a Surgical Neonatal Intensive Care Unit: Development, Implementation and Audit from 2014 to 2023

Journal of Perinatology volume 45, pages 1129–1136 (2025)Cite this article

Subjects

Abstract

Objective

The design, implementation and audit of a multidisciplinary advanced neonatal resuscitation education initiative for “in unit” events in a quaternary NICU over a 9-year period, divided into 3-year epochs of “pre”, “implementation” and “maintenance” is described.

Study design

A didactic and simulation quality improvement initiative focused on teaching and reinforcing specific algorithms endorsed by the American Heart Association (AHA) to target resuscitation needs of older neonates including surgical and cardiac conditions. Qualitative and quantitative data pre and post implementation was audited.

Results

Post education implementation, team members performed quicker hemodynamic assessments and applied CPR and/or bolus epinephrine correctly in higher proportions during acute events. During supraventricular tachycardia, vagal maneuver use and medication administration time improved.

Conclusion

Advanced neonatal resuscitation education and reinforcement targeted for event etiology, allow for AHA algorithms to be successfully taught and performed within a quaternary NICU with improvement in hemodynamic assessments and AHA algorithm implementation.

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Fig. 1: Methodology for the development of an Advanced Neonatal Resuscitation Education Program: including identification of resuscitation education needs, development of didactic and simulation-based curriculum and maintenance education strategies.
Fig. 2: Total number of documented code events and etiology of events included in analysis and sub-analysis.
Fig. 3: Time of first recorded blood pressure or hemodynamic assessment during pre-implementation epoch (2014–16), implementation epoch (2018–20), and maintenance/current epoch (2021–23).
Fig. 4

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors are grateful for the support by members of the administrative and clinical team. We would like to acknowledge Milton Perla’s expertise and knowledge, Ms. Athina Alight and Ms. Katrina Hsu for reviewing code documentation, Ms Elle Djogovic for assistance in Figure generation, Dr. Allan de Caen for thoughtful review, and Dr. Matt Hicks for statistical guidance.

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Author notes

  1. These authors contributed equally: Nicole M. Anderson, Chloe Joynt

Authors and Affiliations

  1. Division of Neonatology, Department of Pediatrics, University of Alberta, Edmonton, AB, Canada

    Nicole M. Anderson & Chloe Joynt

  2. Alberta Health Services, Stollery NICU, Edmonton, AB, Canada

    Andrea Kitchen & Amy McKenzie

Authors
  1. Nicole M. Anderson
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  2. Andrea Kitchen
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  3. Amy McKenzie
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  4. Chloe Joynt
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Contributions

AG, AM and CJ contributed to the idea, development and implementation of an advanced neonatal resuscitation course. NA and CJ performed a literature review, data collection/analysis, drafted the initial manuscript, and reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of work.

Corresponding author

Correspondence to Nicole M. Anderson.

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Competing interests

The authors declare no competing interests.

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This was a quality improvement initiative; ethics approval and consent was waived.

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Anderson, N.M., Kitchen, A., McKenzie, A. et al. An Advanced Neonatal Resuscitation Educational Program in a Surgical Neonatal Intensive Care Unit: Development, Implementation and Audit from 2014 to 2023. J Perinatol 45, 1129–1136 (2025). https://doi.org/10.1038/s41372-024-02192-y

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