Team training in obstetric and neonatal emergencies using highly realistic simulation in Mexico: impact on process indicators

被引：58

作者：

Walker, Dilys ^{[1
,2
]}

Cohen, Susanna ^{[3
]}

Fritz, Jimena ^{[4
]}

Olvera, Marisela ^{[4
]}

Lamadrid-Figueroa, Hector ^{[4
]}

Cowan, Jessica Greenberg ^{[5
]}

Gonzalez Hernandez, Dolores ^{[4
]}

Dettinger, Julia C. ^{[1
]}

Fahey, Jenifer O. ^{[6
]}

机构：

[1] Univ Washington, Dept Global Hlth, Seattle, WA 98104 USA

[2] Univ Washington, Dept Obstet & Gynecol, Seattle, WA 98104 USA

[3] Univ Utah, Coll Nursing, East Salt Lake City, UT 84112 USA

[4] Natl Inst Publ Hlth, Res Ctr Populat Hlth, Div Reprod Hlth, Cuernavaca 621000, Morelos, Mexico

[5] Swedish Med Ctr, Clin Fac, Dept Family Med, Seattle, WA 98122 USA

[6] Univ Maryland, Sch Med, Dept Obstet & Gynecol, Baltimore, MD USA

来源：

BMC PREGNANCY AND CHILDBIRTH | 2014年 / 14卷

关键词：

Interprofessional; Obstetric emergencies; Neonatal resuscitation; Simulation; Team training; Limited-resource; LOW-RESOURCE SETTINGS; MATERNAL MORTALITY; CARE; EDUCATION;

D O I：

10.1186/s12884-014-0367-1

中图分类号：

R71 [妇产科学];

学科分类号：

100211 ;

摘要：

Background: Ineffective management of obstetric emergencies contributes significantly to maternal and neonatal morbidity and mortality in Mexico. PRONTO (Programa de Rescate Obstetrico y Neonatal: Tratamiento Optimo y Oportuno) is a highly-realistic, low-tech simulation-based obstetric and neonatal emergency training program. A pair-matched hospital-based controlled implementation trial was undertaken in three states in Mexico, with pre/post measurement of process indicators at intervention hospitals. This report assesses the impact of PRONTO simulation training on process indicators from the pre/post study design for process indicators. Methods: Data was collected in twelve intervention facilities on process indicators, including pre/post changes in knowledge and self-efficacy of obstetric emergencies and neonatal resuscitation, achievement of strategic planning goals established during training and changes in teamwork scores. Authors performed a longitudinal fixed-effects linear regression model to estimate changes in knowledge and self-efficacy and logistic regression to assess goal achievement. Results: A total of 450 professionals in interprofessional teams were trained. Significant increases in knowledge and self-efficacy were noted for both physicians and nurses (p < 0.001-0.009) in all domains. Teamwork scores improved and were maintained over a three month period. A mean of 58.8% strategic planning goals per team in each hospital were achieved. There was no association between high goal achievement and knowledge, self-efficacy, proportion of doctors or nurses in training, state, or teamwork score. Conclusions: These results suggest that PRONTO's highly realistic, locally appropriate simulation and team training in maternal and neonatal emergency care may be a promising avenue for optimizing emergency response and improving quality of facility-based obstetric and neonatal care in resource-limited settings.

引用

页数：11

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