Neonatal resuscitation: a comparative analysis of midwives and midwifery students

Background: At birth, most infants adjust well to the transition from intrauterine to extrauterine life, but some need additional assistance with pacing or resuscitation. It is necessary to investigate the resuscitation competence of the professionals assigned to the care of the newborn, including the midwife, in order to reduce neonatal morbidity and mortality. Aim of the study: The study aims to evaluate the performance of a group of midwives and a group of midwifery students during a neonatal resuscitation simulation with the purpose of investigating their skills, abilities and knowledge of neonatal resuscitation, including compliance with Guidelines and Neonatal Resuscitation Algorithm. Materials and methods: The present study was conducted at the Obstetric and Gynecological Clinic of the Women's and Children's Health Unit of the University of Padua Hospital Company. The study involved 28 people, divided into two categories: 14 midwives from the “delivery room” Operational Unit and 14 students from the Obstetrics course at the University of Padua. The same clinical case was presented to both samples individually, and each participant had to perform the simulation individually. The study samples and individual performance scores were then evaluated and compared for further detailed analysis. Results: Midwives performed correctly 60% of preparation tasks, 47% of initial steps tasks and 30,4% of non-technical skills tasks; while midwifery students respectively 59%, 37,14% and 25%. Midwives didn’t perform or performed incorrectly 27% of preparation tasks, 29% of initial steps tasks and 52,2% of non-technical skills tasks; while midwifery students respectively 21%, 41,43% and 57,1%. The results also highlighted that correct times for the duration of stimulation and the start of positive pressure ventilation were not maintained in more than the majority of the midwifery students’ group, while as regards the midwife’s group this occurred only in the time of start of positive pressure ventilation, as it stimulated at correct times in 57% of cases. Conclusions: Although no statistically significant differences emerged regarding the performances for which the p value was calculated, it was still possible to find differences in the ratings assigned to the groups, particularly in the initial steps phase, where better results were achieved from the midwifery group. In some cases, non-compliance with the Neonatal Resuscitation Algorithm was found in both groups, especially in maintaining the correct times. Finally, this study aims to underline the importance of adequate training in neonatal resuscitation, both in university and continuous training as the midwife is the first figure who provides care to the newborn at birth.