Date of Award

Spring 5-25-2024

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice



First Advisor

Charisse Lyn Tabotabo, DNP, CNE, CHSE, RN-BC, RNC-NIC


Neonatal resuscitation is a low-volume, high-risk occurrence. Given the infrequency of resuscitation, newer neonatal intensive care unit (NICU) nurses may have little to no exposure to neonatal resuscitation events. This can lead to a lack of confidence in resuscitation skills, contributing to burnout, poor patient outcomes, and the potential for nursing turnover. This evidence-based practice project, guided by the Iowa Model Revised: Evidence-Based Practice to Promote Excellence in Health Care, focused on enhancing the perceived confidence in neonatal resuscitation skills among newer NICU nurses. To achieve this, multidisciplinary, high-fidelity, in-situ neonatal resuscitation crisis resource management (CRM) simulated events were implemented. Confidence in resuscitation skills before and after the CRM event was self-reported by each nurse participant using the 5-item Confidence Scale (C-Scale). Nine nurses with less than three years of NICU experience in a level III NICU participated in a single CRM event between April 2023 and November 2023. There was a statistically significant difference in the mean confidence scale score pre-CRM (M = 12) and post-CRM (M = 17) as per the Wilcoxon signed-rank test (Z = -2.558, p = 0.011). Implementing high-fidelity, in-situ neonatal resuscitation CRM events significantly enhances newer NICU nurses’ confidence in resuscitation skills. This improvement in confidence is expected to lead to better patient outcomes, reduced nurse burnout, and higher nurse retention rates. Repeated assessments of perceived confidence 3- and 6-months post-CRM should be explored to determine the sustained effect of the CRM.