Evaluating the Effect of Interdisciplinary Simulation Training on Provider Comfort in the Management of Postpartum Hemorrhage (PPH) in a Low-Resource Setting [ID: 1363496]

Paxton E. Voigt, Sasha Hernandez, Beralis Ramos, T. Shirazian
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Abstract

INTRODUCTION: Maternal mortality from postpartum hemorrhage (PPH) can be reduced through timely management. Interdisciplinary simulation-based training (SBT) has been shown to improve team response to PPH, but SBT is not widely available in low-resource settings. The purpose of this study is to assess the acceptability of SBT and its effect on interdisciplinary personnel’s self-efficacy in a low-resource setting. METHODS: A pilot low-fidelity PPH SBT program using PRONTOPack was conducted from November 2021 to September 2022 after an initial audit revealed inadequate training at a public teaching hospital with the highest national maternal mortality rate in the Dominican Republic. Thirty interdisciplinary providers were trained in two cohorts. Self-efficacy was assessed via anonymous, postsimulation surveys. RESULTS: One hundred percent of providers reported that the SBT was an effective form of training that will help them manage PPH in the future. In the first cohort (n=7), providers reported high comfort with their teamwork (4.57/5 S 0.49) and communication skills (4.29/5 S 0.45) after SBT. In the second cohort (n=23), 100% of trainees agreed that SBT improved their ability to communicate effectively, work in teams, and manage PPH. CONCLUSION: Low-fidelity interdisciplinary SBT was found to be useful in improving trainees’ self-perceived nontechnical skills in the management of PPH. Most notably, communication skills were improved between providers that routinely manage real-time PPHs in clinical practice. Next steps are to integrate and standardize SBT into the obstetric department’s workflow to train all personnel managing PPHs.
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跨学科模拟培训对低资源环境下产后出血护理人员舒适度的影响[j]
导言:产后出血(PPH)的产妇死亡率可以通过及时的管理来降低。基于跨学科模拟的培训(SBT)已被证明可以改善团队对PPH的反应,但SBT在资源匮乏的环境中并没有广泛应用。摘要本研究旨在探讨低资源环境下跨学科人员的自我效能感及其可接受性。方法:在初步审计发现多米尼加共和国全国孕产妇死亡率最高的公立教学医院培训不足后,于2021年11月至2022年9月使用PRONTOPack进行了低保真PPH SBT试点项目。30名跨学科提供者接受了两组培训。自我效能感通过匿名模拟后调查进行评估。结果:100%的提供者报告SBT是一种有效的培训形式,将帮助他们在未来管理PPH。在第一队列(n=7)中,提供者报告了SBT后他们的团队合作(4.57/5 S 0.49)和沟通技巧(4.29/5 S 0.45)的高舒适度。在第二组(n=23)中,100%的学员认为SBT提高了他们有效沟通、团队合作和管理PPH的能力。结论:低保真度跨学科SBT有助于提高学员在PPH管理中自我感知的非技术技能。最值得注意的是,在临床实践中,日常管理实时pph的提供者之间的沟通技巧得到了改善。接下来的步骤是将性传播感染纳入产科部门的工作流程并使之标准化,以培训所有管理小灵通的人员。
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