Study protocol for implementing videorecording of acute neonatal interventions to create reflexivity; the Neoflix project

Abstract Purpose: The environment of the NICU can be dynamic and emergent. Video-reflection of neonatal interventions gives an objective view on clinical practice. Although video-reflection is increasingly used, it is focused mostly on technical aspects. The focus of video-reflection can also be shifted towards teamwork and context. However, no studies have explained the set-up for video-reflexive sessions of neonatal interventions and how to use it to drive change and improvement neonatal interventions. We aim to identify success factors and prerequisites for implementation of video-reflexivity and to create a manual for other departments. Methods: video-reflexive sessions will be conducted at the NICU of the LUMC. Interventions that are recorded include 1) line insertions, 2) intubations and MIST procedures and 3) neonatal resuscitations at birth. Caregivers can choose to record interventions they perform, are offered the option of reviewing the recordings and are invited to attend the multidisciplinary reflexive sessions. Observations regarding insights, ideas and discussions will be evaluated. Action-research will be performed to make improvements in neonatal care based. Results and conclusion: Institutional research ethics approval has been acquired. Results will be published in peer-reviewed journals and presented at relevant conferences. Findings will be presented to caregivers to inform them of ongoing improvements of neonatal interventions. Time is limited in an acute care department, not all caregivers can attend each session. We distribute findings from the reflexive sessions among all caregivers. Our proposal is based on the experience of a single center level III NICU.