Shhh I'm growing: noise in the NICU.

Attempting to mitigate operational and structural noise is important in improving the outcomes of high-risk preterm infants. It was anticipated that a culture change in nursing behaviors to include "Quiet Time" would result in reducing the noise levels towards the National Recommended Safe Sound Level. This culture change alone was inadequate to meet NRL. Both operational and structural changes were also required in order to provide a safer neurophysiological environment for the rest and growth of the neonate.

Improvements in teamwork during neonatal resuscitation after interprofessional TeamSTEPPS training.

PURPOSE: To determine the impact of interprofessional Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS ) training on teamwork skills during neonatal resuscitation. DESIGN: Teams of physicians, nurses, and respiratory therapists participated in TeamSTEPPS training that included simulation with an event-based approach. During the simulations, scripted medication order and performance errors were used to test teamwork skills. Measures of teamwork skills were obtained before and after the training using a prospective pretest-posttest design. SAMPLE: Forty-two physicians, nurses, and respiratory therapists. MAIN OUTCOME VARIABLE: Teamwork skills. RESULT: Significant improvements in teamwork skills were seen in team structure, leadership, situation monitoring, mutual support, and communication (p ,.001). Challenges by nurses to a scripted medication order error doubled from 38 percent before the training to 77 percent after the training. The odds of a nurse challenging an incorrect medication dose from an attending neonatologist improved significantly. Detection and correction of inadequate chest compressions increased from 61.5 to 84.6 percent after the training.