76 - Neonatal Procedural Simulation Program for Maintenance of Hospital Credentialing

Maintenance of hospital credentialing for high-risk procedures performed in the neonatal intensive care unit (NICU) is an ongoing challenge with limited opportunities and multiple staff and trainees. A simulation-based procedural program may help providers supplement clinical procedural experience to maintain credentialing.

Objective:

To utilize simulation as a tool to increase the percentage of APPs who maintain hospital credentialing to perform different NICU procedures by at least 20%.

Design/Methods:

APPs participated in a monthly education program on 13 neonatal procedures, consisting of asynchronous online learning (presentations, videos, policies, clinical cases) and simulation-based demonstration of procedural skills utilizing standardized, evidence-based checklists with a colleague. During the year-long credentialing period, APPs electronically logged clinical procedures performed successfully. APPs did not recredential if they did not perform specific procedure(s) at least once clinically. In contrast, APPs who performed the clinical procedure twice automatically recredentialed, while those who performed the procedure once were able to supplement their clinical experience by demonstrating their skills in a simulation. We calculated the proportion of APPs who: 1) did not meet criteria for credentialing, 1) met criteria for credentialing with ≥2 clinical procedures, 2) met criteria for credentialing with 1 clinical plus 1 simulated procedure. Data were analyzed with descriptive statistics.

Results:

During 2021-22, 43 APPs participated in the program (Table). None of the APPs were credentialed for 2 (15%) rare procedures: intraosseous placement and pericardiocentesis (Figure 1). For the remaining 11 (85%) procedures, 4-85% of APPs were credentialed with clinical experience alone, and another 4-35% were credentialed after demonstrating their skills in a simulation (Figures 1-2). The program helped increase the percentage of credentialed APPs by 20% for 7/13 (54%) procedures, helping most for exchange transfusion, lumbar puncture, and thoracentesis (Figure 2).

 

Conclusion(s):

The neonatal procedural simulation program helped a large group of APPs achieve hospital recredentialing while providing standardized education. Structured as asynchronous learning and assessment, the program provides a framework for other NICUs to support APPs in their professional development to provide ongoing high-quality patient care.