NRP updates in Indicators Version 1.1
The Commission for the Accreditation of Birth Centers (CABC) has published Version 1.1 of the CABC Indicators and revised several indicators related to the resuscitation of newborns in CABC-accredited birth centers.
These changes were prompted both by evidence-based updates in the Neonatal Resuscitation Program (NRP)(http://www2.aap.org/NRP/7thedinfo.html) and by the CABC’s need to address inconsistent regulations and restrictions across states related to midwifery scope of practice.
It has long been the stance of CABC that birth centers must offer families the standard of care when it comes to resuscitation. The CABC realizes and acknowledges that the need to perform the advanced skills of resuscitation such as intubation or intravenous medications for a baby in a CABC-accredited birth center represents a fraction of the 1% that NRP estimates. However, to date, there is no evidence to support the idea that a midwife, with good training and routine simulation drills, is less able to perform the skills necessary to insert a laryngeal mask airway, start an IV, or administer epinephrine to a newborn. Therefore each state should strive to meet national standards regarding neonatal resuscitation and allow midwives to practice to the fullest reasonable extent in providing resuscitative measures to newborns.
The revised indicators:
- Allow birth centers to choose whether they prefer to use the laryngeal mask airway or intubation as their advanced airway modality (either is acceptable to the NRP Guidelines).
- Clearly state that birth centers are expected to have the ability to provide intravenous therapy and medications during the course of newborn resuscitation in accordance with NRP algorithm.
- Describe the ideal interdisciplinary environment for successful readiness, including communication between the birth center, emergency responders and tertiary care and joint simulation drills
- Permit the possibility of accreditation for birth centers in the rare states who have specific written restrictions or regulations that prevent midwives from performing a complete resuscitation algorithm.
A complete list of all changes in the newest edition of the CABC Indicators for Compliance with the Standards for Birth Centers can be found on page 7 of that document. From this page, you can select a link to each change in the document.
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