The perceived workload of first-line healthcare professionals during neonatal resuscitation
Background
Neonatal resuscitation is an intense and high-stress process for healthcare professionals. The National Aeronautics and Space Administration-Task Load Index (NASA-TLX) has been used to measure the perceived workload in such settings. However, little is known about how workload perception differs between medical doctors (MDs) and nurses/midwives, given their varying training backgrounds and clinical experiences. This study aimed to characterize and compare the perceived workload of MDs and nurses/midwives involved in neonatal resuscitation.
Methods
A prospective, cellphone-based surveillance was conducted to evaluate the perceived workload and stress of MDs and nurses/midwives using a modified multi-dimensional NASA-TLX survey. The study took place in three tertiary Neonatal Intensive Care Units (NICUs) in China. Participants independently rated six NASA-TLX dimensions: mental demand, physical demand, temporal demand, performance, effort, and frustration. These scores were collated into a composite workload score. Additionally, participant demographics and delivery details were collected for statistical analysis using univariate comparisons and multiple linear regression.
Results
A total of 410 valid surveys were analyzed (187 MDs (46%) and 223 nurses/midwives (54%)). Significant differences were observed between MDs and nurses/midwives in terms of work experience and NASA-TLX scores. Key findings include:
MDs reported lower overall NASA-TLX scores than nurses/midwives.
Simulation-based training was associated with lower NASA-TLX scores among MDs.
Increased team member presence during resuscitation was correlated with higher NASA-TLX scores.
Factors independently associated with NASA-TLX scores included gestational age, Apgar score at 1 minute, years of practice for MDs, and the number of resuscitation-related questions asked by nurses/midwives.
Conclusions
MDs and nurses/midwives perceive neonatal resuscitation stress differently. While nurses/midwives reported higher workload scores, simulation-based training was associated with reduced perceived stress among MDs. The presence of additional team members during resuscitation was linked to increased workload perception, highlighting the importance of optimizing team dynamics and training to improve neonatal resuscitation experiences. Future strategies should focus on tailored training programs to mitigate stress and enhance performance in high-pressure neonatal care environments.
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