Neonatal Lumbar Punctures: Bridging the Clinical Gap

Abstract

Abstract Lumbar puncture (LP) is a commonly performed procedure in the neonatal intensive care unit (NICU). Lumbar punctures are performed for several indications, but perhaps the most important is to aid in the diagnosis of neonatal meningitis. This condition often presents in a nonspecific fashion, can be difficult to diagnose utilizing clinical skills alone, and is closely linked to sepsis. Following a performance audit of LPs at an academic Level 4 NICU, several areas of concern were identified. To address deficiencies associated with proper technique and procedural skills, a novel, simulation-based educational curriculum was developed. The module includes a PowerPoint presentation that walks learners through the simulated procedure, pre- and postassessment surveys, and an instructor's guide. Knowledge was assessed using a multiple-choice quiz, while self-rated surveys were used to capture learner self-efficacy. A validated objective structured assessment of technical skills instrument was utilized to assess LP procedural skill during live observation in a simulated setting. Pre-post comparison of quiz scores was performed using paired-student t test, while differences in performance ratings were analyzed using a many-facet Rasch model. It is our hope that this educational intervention will positively impact learner's knowledge, self-efficacy, and LP performance in a simulated setting. Ultimately we hope to assess the success of this intervention with respect to live LPs and clinical outcomes.

Keywords

• Resident Education
• Lumbar Puncture
• Spinal Puncture
• Neonatal
• Simulation Education