Birth in the Emergency Department

Abstract

The use of high-fidelity simulation increases emergency department (ED) staff preparedness in high-risk, low-volume obstetric emergencies. ED staff will be better prepared and more confident in providing appropriate standards of care to the obstetric and newborn populations. A variety of evidence was used, including professional nursing association position statements, evidence-based procedures, nationally recognized care guideline, well-designed case control and cohort studies, and single descriptive studies. Two obstetric/ED simulation scenarios for an unexpected, precipitous birth were developed using high-fidelity simulation manikins. Eighty-five ED staff completed the simulation and debrief session. All survey questions addressing staff confidence and preparedness saw large increases in staff feeling prepared and confident. In addition, for knowledge-based questions, there was an 80% increase in correct answers. The obstetric–newborn population in the ED saw a 90% decrease in incident reports after the simulation sessions. The results suggest that simulation-based educational interventions have a strong effect on nurse confidence, knowledge and preparedness when preparing for the low volume, high risk OB/newborn patient population.