Building Confidence and Team Communication: Implementation of a Rapid Response In Situ Simulation Program in the Neonatal Intensive Care Unit

Author

• Janell F. Hacker, University of KentuckyFollow

Date Available

4-30-2026

Year of Publication

2026

Document Type

DNP Project

Degree Name

Doctor of Nursing Practice

College

Nursing

Department/School/Program

Nursing

Faculty

Dr. Laura Hieronymus

Committee Member

Dr. Anthony Haase

Faculty

Dr. Holly Chitwood

Faculty

Dr. Amanda Wiggins

Abstract

Background: Neonatal code events are high-risk, low-frequency occurrences in the neonatal intensive care unit (NICU). Simulation-based training is used to support skill development, maintain competencies, and enhance team performance.

Purpose: The purpose was to determine if a multidisciplinary, high-fidelity, rapid response in situ simulation program would impact confidence and communication among frontline healthcare providers during neonatal code events.

Methods: A quasi-experimental, pretest-posttest study was conducted in a 90-bed Level IV NICU. A multidisciplinary, high-fidelity in situ rapid response simulation program was implemented over a 3-month period for frontline NICU healthcare providers. Pre- and post-surveys assessed perceptions of role clarity, confidence, leadership, communication, psychological safety, and team performance.

Findings: A significant increase in the composite mean survey score (p < .001) following the intervention indicated a positive impact of the simulation program. Significant improvements were observed in role understanding and clarity (p = .010), psychological safety (p < .001), debriefing (p < .001), and satisfaction with team performance (p < .001). Participant responses regarding confidence, leadership, and communication increased but did not show statistical significance.

Implications for Practice: These findings highlight the importance of continued development, refinement, and sustainability of simulation-based programs in the neonatal setting. Targeted education and training initiatives aimed at improving communication, leadership, and confidence may further strengthen team performance.

Implications for Research: Future research should assess the direct impact of simulation on patient outcomes.

Recommended Citation

Hacker, Janell F., "Building Confidence and Team Communication: Implementation of a Rapid Response In Situ Simulation Program in the Neonatal Intensive Care Unit" (2026). DNP Projects. 520.
https://uknowledge.uky.edu/dnp_etds/520