322 - Effect of Respiratory Function Monitor Use on Team Leaders’ Subjective Workload During Neonatal Resuscitation of Very Preterm Infants

Poster Number: 322
Publication Number: 322.348

Brenda H. Law, University of Alberta Faculty of Medicine and Dentistry, Edmonton, AB, Canada; Faith Trinh, University of Alberta Faculty of Medicine and Dentistry, Edmonton, AB, Canada; Georg Schmoelzer, University of Alberta Faculty of Medicine and Dentistry, Edmonton, AB, Canada

Background: Respiratory Function Monitors (RFM) provide real-time mask ventilation data to healthcare providers (HCPs) during neonatal resuscitation (NR). RFM use may decrease neonatal brain and lung injury by assisting HCPs in reducing mask leak, detecting airway obstruction, and controlling tidal volumes (V_T). However, RFM use might affect HCPs’ mental and physical workload. NASA-Task Load Index (NASA-TLX) have been used to quantify subjective workload during NR, measuring mental, temporal, and physical demands as well as effort, frustration, and performance.

Objective: We aim to compare NASA-TLX of team leaders performing resuscitations of very preterm infants with and without RFM.

Design/Methods: We performed a 2-phase interventional study. First, we aimed to obtain NASA-TLX surveys from at least 32 team leaders post delivery room resuscitation of infants < 32 weeks using vital signs monitor only (Phase 1). In Phase 2, potential team leaders were trained at short sessions to incorporate RFM data in decision-making. Suggested V_T goals were posted as cognitive aids. Then, we aimed to obtain data from 32 resuscitations with RFM added, with the same team leaders as in Phase 1 when possible.

Results:

Study occurred from October 2020 to December 2021. We obtained data from 79 resuscitations, 48 in Phase 1, 31 in Phase 2. Thirty-five team leaders provided data for Phase 1, 24 for Phase 2, and 16 for both. Infants were median of 28 weeks, birth weight of 1110g. Most had mask ventilation (86%). Infant characteristics were similar between groups.(Table 1)

When data was available (n=16), the first resuscitation reported by each team leader for each phase were compared using paired analysis. There were no differences in any NASA-TLX domain or total score. All team leader responses were also compared, assuming independence. No difference in any NASA-TLX domain or total NASA-TLX were found with RFM use.(Table 1)

Using regression, the effect of RFM use, gestation, birth weight, maximum FiO2, and team leader years of experience on NASA-TLX was evaluated. Max FiO₂ corresponded to higher scores in all domains while years of experience affected performance and effort. Max FiO2 and years of experience together explained 22% of variations in total NASA-TLX (F(1,71)=9.8, p=0.039). Each 10% increase in max FiO2 is associated with a total NASA-TLX increase of 2.5. Each year of experience resulted in an increase total NASA-TLX of 0.5.

Conclusion(s): Team leaders did not report increased workload with RFM use during delivery room resuscitation of very preterm infants. Workload was most influenced by patient acuity and HCP experience.