Effect of on-site training on the accuracy of blood loss estimation in a simulated obstetrics environment

Abstract

Objective: To determine the effect of on-site training on the accuracy of blood loss estimation in a simulated obstetrics environment.

Methods: In a tertiary hospital in Nigeria, clinical scenarios were created in April 2013 using known blood volumes in an objective structured clinical examination fashion. Doctors and nurses who worked in the obstetrics unit observed and recorded the blood volume at different clinical stations (first study stage). Subsequently, the actual amount of blood was revealed, followed by on-site training on the volume capacities of the study instruments. Three weeks later, the second stage of the study was performed like the first stage but using different amounts of blood for all stations. The differences in the mean errors of blood loss estimation between the two stages were determined.

Results: The analysis included 144 healthcare providers who completed both stages of the study. There were significant differences in the mean error of blood loss estimation before and after the training session for the following stations: delivery bed (P<0.001), sanitary pad 1 (P=0.001), sanitary pad 2 (P=0.001), delivery pad (P=0.001), floor (P<0.001), and laparotomy pad (P=0.001).

Conclusion: Periodic education by simulation using clinical scenarios could improve the accuracy of visual blood loss estimation.

Keywords: Accuracy; Blood loss; Simulation; Training; Visual estimation.