Objective Accurate documentation in healthcare is necessary for ethical, legal, research and quality improvement purposes. In this review, we aimed to evaluate the accuracy of methods of documentation of delivery room resuscitations. Methods A systematic literature search in MEDLINE was conducted to identify original studies that reported the quality of documentation records during newborn resuscitation in the delivery room. Data extracted from the studies included population characteristics, methodology, documentation protocols, use of gold standard and main results (initial assessment of heart rate and peripheral oxygen saturation, respiratory support and supplementary oxygen). Results In total, 197 records were screened after initial database search, of which seven studies met the inclusion criteria and were finally included in this review. Four studies were chart reviews and three studies compared conventional documentation methods with video recording. Only one study tested an intervention to improve documentation. Documentation was often inaccurate and important resuscitation events and interventions were poorly recorded. Lack of uniformity among studies preclude pooled analysis, but it seems that complex or advanced procedures were more accurately reported than basic interventions. Conclusions There is little literature regarding accuracy of documentation during neonatal resuscitation, but current quality of documentation seems to be unsatisfactory. There is a need for consensus guidelines and innovative solutions in newborn resuscitation documentation. Data sharing not applicable as no datasets generated and/or analysed for this study. All data relevant to the study are included in the article or uploaded as supplementary information. No unpublished data are available for this study.

中文翻译：

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新生儿复苏期间的记录：系统评价

目标 出于伦理、法律、研究和质量改进的目的，准确的医疗保健文件是必不可少的。在本次审查中，我们旨在评估产房复苏记录方法的准确性。方法 在 MEDLINE 中进行了系统的文献检索，以确定报告产房新生儿复苏过程中文件记录质量的原始研究。从研究中提取的数据包括人群特征、方法、文件协议、黄金标准的使用和主要结果（心率和外周血氧饱和度的初步评估、呼吸支持和补充氧气）。结果初步数据库检索后共筛选出197条记录，其中7项研究符合纳入标准，最终纳入本综述。四项研究是图表审查，三项研究将传统记录方法与视频记录进行了比较。只有一项研究测试了改进文档的干预措施。文件记录通常不准确，重要的复苏事件和干预措施的记录也很差。研究之间缺乏一致性排除了汇总分析，但似乎复杂或高级程序比基本干预更准确地报告。结论 关于新生儿复苏过程中记录准确性的文献很少，但目前的记录质量似乎并不令人满意。新生儿复苏文档需要共识指南和创新解决方案。数据共享不适用，因为没有为本研究生成和/或分析的数据集。与研究相关的所有数据都包含在文章中或作为补充信息上传。本研究没有未发表的数据。