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Controlled Clinical Trial
. 2014 Nov 20:14:367.
doi: 10.1186/s12884-014-0367-1.

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

Dilys Walker  1   2 , Susanna Cohen  3 , Jimena Fritz  4 , Marisela Olvera  5 , Hector Lamadrid-Figueroa  6 , Jessica Greenberg Cowan  7 , Dolores Gonzalez Hernandez  8 , Julia C Dettinger  9 , Jenifer O Fahey  10
Affiliations
Controlled Clinical Trial

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

Dilys Walker et al. BMC Pregnancy Childbirth. .

Abstract

Background: Ineffective management of obstetric emergencies contributes significantly to maternal and neonatal morbidity and mortality in Mexico. PRONTO (Programa de Rescate Obstétrico y Neonatal: Tratamiento Óptimo 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.

Trial registration: NCT01477554.

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Figures

Figure 1
Figure 1
The PartoPants™ are a low-cost, low-technology based birth simulator used for simulations during PRONTO International trainings.
See this image and copyright information in PMC

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