EFFECT OF AN EDUCATIONAL PRESENTATION ON KNOWLEDGE AND ATTITUDES TOWARDS MANAGEMENT OF EXTREMELY PREMATURE INFANTS

SDoucette, SAkiki, BLemyre, TDaboval, SDunn, NBarrowman, GMoore

Affiliations: Children’s Hospital of Eastern Ontario, CHEO Clinical Research Unit, BORN Ontario

Background: A guideline regarding perinatal management of extremely premature infants (EPI – 22-25 wks GA) is being developed in Ottawa. Currently, no research has examined the effect of healthcare providers (HCP) education on knowledge and attitudes regarding EPI, despite assessment of barriers and facilitators being critical for guideline implementation.

Objectives: 1) To determine if HCP knowledge of and attitudes towards EPI were changed by attending a presentation about survival and neurodevelopmental impairment (NDI) of EPI and associated ethical issues; and, 2) to explore the correlation between knowledge and attitudes of HCP.

Methods: Local HCP (neonatal and obstetrical nurses, trainees and consultants; pediatricians) working with EPI and parent(s) attended a presentation. Participants completed a pre/post survey. Changes in knowledge and attitudes were analyzed using the McNemar test and marginal homogeneity test. Association between knowledge and attitudes was assessed using Spearman correlation.

Results: 160 of 508 potential participants attended a presentation (attendance rate = 31%); 130 completed both surveys (response rate = 81%). HCP knowledge significantly improved following the presentation for all GA (p≤0.001). Of 16 questions assessing HCP attitudes, all but one demonstrated a significant ‘positive’ shift in modal category (i.e. more likely to consider resuscitation) (p=0.04 to p<0.001) after the presentation. Based on post-presentation responses, HCP knowledge correlated with certain attitudes toward resuscitation (example, Figure). Other attitudes did not significantly correlate with HCP knowledge (eg. willingness to use epinephrine during resuscitation of a 24 wk infant did not significantly increase if HCP believed survival rates to be higher (p = 0.16)).

Conclusions: The survey results revealed a statistically significant improvement in knowledge and alteration in attitudes of HCP after attending a presentation about EPI. The correlation between knowledge and attitudes varied.