Nurses play a major role in assessing and intervening with the parents of infants who are at high risk for sudden death to minimize potential problems following discharge from the hospital. Teaching parents how to respond to a respiratory and/or cardiac arrest in their infant with appropriate resuscitation techniques has become standard nursing discharge practice in many hospitals. It is not clear what effect such discharge teaching has on the psychosocial adaptation of parents, nor ultimately on the survival of infants who experience an at-home arrest. The objective of this research is to test the effects of a nursing intervention designed to teach parents of high-risk infants how to respond to a life-threatening emergency in the home. Project goals are: to describe the psychosocial responses and care seeking behaviors of parents who learn cardiopulmonary resuscitation (CPR) techniques; to compare three methods of teaching CPR to parents of high-risk neonates; to test a social support intervention designed to mitigate the possible negative psychosocial response of parents to learning resuscitation techniques; to test a self-paced learning module that is designed to teach parents CPR; to document the level of CPR knowledge and skill retention by parents over time; and to document the response of parents to a sudden death event. The project aims will be addressed in a multi-center prospective clinical trial. The parents of three hundred infants at high-risk for sudden death will be randomized to one of three groups: a CPR-only group, a condition similar to the information provided by most nurses; a CPR education and social support group, a condition that combines standard American Heart Association information about emergency care with social support measures; or a CPR-programmed instruction group, in which parents will learn CPR by means of a self-paced learning module. It is hypothesized that CPR training, when combined with a social support intervention, will facilitate parental psychosocial adaption, promote functional family processes, and ultimately, lead to increased survival of high risk infants.
