Abstract
INTRODUCTION: To analyze the effectiveness of a multidisciplinary simulation program aimed at reducing perineal lacerations during childbirth. METHODS: A retrospective analysis of quality metrics was performed for a mixed-modality simulation program that was adapted for a large multi-hospital system and disseminated to nurses, midwives and physicians. This inter-professional educational program included multiple teamwork strategies aimed at reducing perineal lacerations. Outcome measures included laceration rates and length of hospital stay for patients with lacerations. Linear regression was used for statistical analysis. RESULTS: Data was examined over a 3-year period including the year prior to and 2 years after the program was initiated. Reductions in laceration rates occurred for spontaneous vaginal deliveries (29.6/1000 to 6.7/1000, R2 = 0.68, p less than 0.001) and operative vaginal deliveries (135.1/1000 to 46/1000, R2 = 0.23, p=0.09). Average hospital length of stay for patients with lacerations was reduced from 1.12 to 0.94 days during the program implementation (R2 = 0.36, p=0.05). CONCLUSION: Modest reductions in perineal laceration rates and hospital length of stay were demonstrated through a multifactorial inter-professional educational program. Reducing severe perineal laceration rates benefits patients and hospital systems.
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