Introduction: Human errors or protocol deviations during neonatal resuscitation are common. Excess workload has been proposed as a contributor to human error during medical tasks. Our aim is to characterize healthcare providers (HCP) experience of workload and determine how various factors are associated with a perceived workload of HCPs during neonatal resuscitation.
Methods: The perceived workload was measured using the multi-dimensional retrospective National Aeronautics and Space Administration Task Load Index (NASA TLX) survey. Mental demand, physical demand, temporal demand, performance, effort and frustration, are all considered on this survey with each rated independently by participants on a scale of 0-20 (0 being lowest or best and 20 being highest or worse depending on the dimension). The Raw TLX score is the overall workload score which is the composite of all dimensions. Over a three-month period, HCPs at the Royal Alexandra Hospital, Edmonton, AB were asked to complete a paper and pencil survey following their participation in neonatal resuscitation in the delivery room.
Results: A total of 204 surveys were completed. The Raw TLX workload score for all respondents was 42 (22.8). The median (IQR) scores varied by dimension mental demand 10 (5-14), physical demand 4 (1-6), temporal demand 8 (3-14), performance 4 (2-6), effort 8 (4-13), and frustration 4 (1-10). Raw TLX workload scores differed between resuscitations based on the 5-minute Apgar score of the baby. Resuscitations on babies with low 5-minute Apgar (0-3) had a median (IQR) Raw TLX of 54.2 (48.3- 60.8), medium 5-minute Apgar (4-7) of 38.3 (30.0- 48.3), and high 5-minute Apgar (8-10) of 25.0 (12.5- 39.55).
Conclusion: Perceived workload during neonatal resuscitations was highly variable and differed by babies 5-minute Apgar scores. Mental demand, temporal demand and effort played the largest role in HCP experience of workload during neonatal resuscitation.
Brenda Law– Neonatologist, Centre for the Studies of Asphyxia and Resuscitation, Royal Alexandra Hospital, Edmonton, Canada, Department of Pediatrics, University of Alberta, Edmonton, Canada
Sylvia van Os– Research Respiratory Therapist, Centre for the Studies of Asphyxia and Resuscitation, Royal Alexandra Hospital, Edmonton, Canada
Georg Schmolzer– Clinician Researcher, Centre for the Studies of Asphyxia and Resuscitation, Royal Alexandra Hospital, Edmonton, Canada, Department of Pediatrics, University of Alberta, Edmonton, Canada