Telecoaching Improves Positive Pressure Ventilation Performance During Simulated Neonatal Resuscitations.

Introduction: Positive pressure ventilation (PPV) is a critical skill for neonatal resuscitation. We hypothesized that telecoaching would improve PPV performance in neonatal providers during simulated neonatal resuscitations.

Setting: Level IV neonatal intensive care unit (NICU).

Decreasing radiographs in neonates through targeted quality improvement interventions.

Objective: Our aim was to decrease radiograph use for monitoring placement of peripherally inserted central catheters (PICC) and endotracheal tubes (ETT) in neonates admitted to the neonatal intensive care unit (NICU) by 20% from November 2017 to November 2018.

Study Design: We carried out three Plan-Do-Study-Act (PDSA) cycles: (1) implementation of a radiograph protocol emphasizing ideal patient positioning, standard radiograph views and frequency, (2) standardizing ETT depth using the NRP guidelines, and (3) implementation of an institution specific ETT depth guideline.

Results: The pre-intervention radiographs per PICC day was 0.

Point-of-care ultrasound for peripherally inserted central catheter monitoring: a pilot study.

Objective To assess the feasibility and accuracy of point-of-care ultrasound (POCUS) in monitoring peripherally inserted central catheter (PICC) location in neonates by non-radiologist physicians. Methods A prospective cohort study compared PICC localization by ultrasound in neonates with a recent radiograph. The ultrasound exam was performed using a standardized protocol with 13-6 MHz linear and 8-4 MHz phased array transducers by a neonatal-perinatal fellow who was blinded to PICC location on the radiograph.

Limited Ultrasound Protocol for Upper Extremity Peripherally Inserted Central Catheter Monitoring: A Pilot Study in the Neonatal Intensive Care Unit.

Objectives: To assess whether a limited ultrasound (US) scanning protocol to monitor the upper extremity peripherally inserted central catheter (PICC) location in neonates is feasible for experienced US operators.

Methods: A radiologist, who was blinded to the PICC location on chest radiography, performed 14 US scans on 11 neonates with upper extremity PICCs. A US machine with 13-6-MHz linear and 8-4-MHz phased array transducers was used for the examinations.

Virtual Antenatal Encounter and Standardized Simulation Assessment (VANESSA): Pilot Study.

Background: Prenatal counseling at the limits of newborn viability involves sensitive interactions between neonatal providers and families. Empathetic discussions are currently learned through practice in times of high stress. Decision aids may help improve provider communication but have not been universally adopted.