The timely and effective evacuation of neonates during emergencies and disasters is an urgent priority identified by the Department of Homeland Security and the Department of Health and Human Services. Neonatal intensive care units provide unique challenges during hospital emergencies requiring evacuation. Training and education of healthcare providers in this environment around best practices to maintain safe, medical care for these critically ill infants are limited but the need is great. One potential innovative method to provide emergency evacuation education and training to healthcare workers is through the use of virtual reality simulation (VRS). Given the paucity of research and evidence pertaining to disaster evacuation of neonates, this proposed study will greatly expand an extremely neglected area. The purpose of this study is to examine differences in learning outcomes among healthcare workers who undergo VRS emergency evacuation training of NICU to those who receive web-based alone. Learning outcomes include a) knowledge gained and retention post VRS compared with traditional learning techniques, b) confidence with evacuation procedures involving infants, and c) psychomotor learning based upon performance in a live evacuation drill. Healthcare worker experiences with VRS will also be explored quantitatively and qualitatively to determine immersiveness, reality, and ability to navigate scenarios. A longitudinal, repeated measures, randomized-experimental design will be instituted with a convenience sample of 90 healthcare workers randomly assigned to the VRS training and web-based modules (45) versus a control group (45) that receives the web-based modules alone. Five VRS scenarios will be created that augment neonate evacuation training materials presented in the web-based modules. Learning will be measured using cognitive assessment, self-efficacy questionnaire and performance in a live drill. Data will be collected at baseline, post, 6, and 12 months and analyzed using generalized estimating equations analysis within a generalized linear model framework. For the qualitative component involving participants'perceptions of the VRS scenarios, content analysis of focus group data will be performed with identification and verification of themes. Results from this study will expand the evidence pertaining to training of healthcare workers as provide evacuation of neonates during a disaster.

Public Health Relevance

The proposed research seeks to improve the health and wellbeing of neonates during an emergency by developing an innovative simulation approach to training healthcare workers in optimal neonatal intensive care unit (NICU) evacuation. Virtual reality simulation training will allow healthcare workers to repeatedly practice evacuation of the NICU so that they are better prepared to respond in the event of an emergency. Virtual reality simulation offers a cost effective method of training, which is available to anyone with an internet-connected computer thereby substantially increasing the availability of training and drills, which will improve neonatal outcomes in the event of disaster evacuation.

National Institute of Health (NIH)
Agency for Healthcare Research and Quality (AHRQ)
Research Demonstration and Dissemination Projects (R18)
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Henriksen, Kerm
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Wright State University
Schools of Nursing
United States
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Farra, Sharon; Hodgson, Eric; Miller, Elaine T et al. (2018) Effects of Virtual Reality Simulation on Worker Emergency Evacuation of Neonates. Disaster Med Public Health Prep :1-8
Farra, Sharon L; Miller, Elaine T; Gneuhs, Matthew et al. (2017) Disaster management: Communication up, across, and down. Nurs Manage 48:51-54
Farra, Sharon; Miller, Elaine T; Gneuhs, Matthew et al. (2016) Evacuation performance evaluation tool. Am J Disaster Med 11:131-136