TOP 4 - Assessing Knowledge and Confidence in Neonatal Code Cart Use: Laying the Groundwork for a Virtual AR Training Tool

Publication Number: 3769.TOP 4

Anu Elangovan, Comer Children's Hospital at University of Chicago Medical Center, Chicago, IL, United States; Gillian Brennan, Comer Children's Hospital at University of Chicago Medical Center, Chicago, IL, United States; Christine Carlos, University of Chicago Division of the Biological Sciences The Pritzker School of Medicine, Chicago, IL, United States; Olivia V. Cangellaris, Comer Children's Hospital at University of Chicago Medical Center, Chicago, IL, United States

Background: Every second counts during neonatal resuscitation, yet delays often occur from something as simple as not knowing where equipment is stored. While neonatal resuscitation algorithms are standardized through the Neonatal Resuscitation Program (NRP), the organization and contents of neonatal code carts vary widely across institutions. This lack of standardization means new or rotating staff may be unfamiliar with the layout of our neonatal code cart, contributing to inefficiencies and potential delays in life-saving interventions. Traditional strategies, such as cart redesign or physical standardization, do not fully address challenges of staff familiarity, workflow variability, or cognitive load under stress. We are developing a virtual code cart using augmented reality (AR) to enhance familiarity and readiness. Prior to implementation, we conducted a pre-intervention needs assessment to evaluate baseline confidence, proficiency, and familiarity with our current cart.

Objective: To assess our neonatal staff members' knowledge and confidence levels with the organizational structure of neonatal code carts and to evaluate the need for an interactive educational tool.

Design/Methods: This study was conducted in two phases at the University of Chicago Comer Children's Hospital, a Level IV neonatal intensive care unit (NICU). In Phase 1, a needs assessment survey was distributed to NICU staff including nurses, residents, fellows, nurse practitioners, and neonatologists. The survey was composed of Likert-scale and open ended questions to assess baseline experience, knowledge, and confidence in utilizing the neonatal code cart. In Phase 2 of the study, individual NICU staff members performed a task in which they were instructed to locate a list of items and medications commonly used in neonatal codes from a fully stocked simulation neonatal code cart. The number of correctly identified items and the time to completion were recorded. The needs assessment and timed task results were completed via a RedCap data collection instrument. Data analysis will be completed by January 2026. Mean confidence levels will be calculated and comparison in responses between the professional roles will be analyzed using t-tests or ANOVA as appropriate. This study was deemed exempt by the University of Chicago Institutional IRB.

Demographic Information
The pie chart details the break down of participants by their roles in the neonatal intensive care unit. The bar chart showcases the different levels of experience of our participants.

Figure 1
This bar chart details the Likert scale responses of the needs assessment results with all participants.

Figure 2
Responses Stratified by Role.1.jpegThese bar charts stratify the Likert scale responses from the needs assessment by role in the NICU.