Does Simulation Team Training in Obstetrics Make a Difference?

Abstract

The simulation of high-risk situations to promote learning and improve performance is not a new concept. The aviation industry is a well-known example of this. Pilots must test and train in flight simulators on a regular basis ( 2 Reznek M. Smith-Coggins R. Howard S. Kivan K. Harter P. Sowby Y. Emergency medicine crisis resource management. Academic Emergency Medicine. 2003; 10: 386-389 Crossref PubMed Google Scholar ). Nursing students train in skill labs prior to actual patient care experiences. Anesthesia and Emergency Departments are using simulation training to improve performance in emergency situations ( 1 DeVita M. Schaefer J. Lutz J. Wang H. Dongill T. Improving medical emergency team (MET) performance using a novel curriculum and a computerized human patient simulator. Quality and Safety in Healthcare. 2005; 14: 326-331 Crossref PubMed Scopus (197) Google Scholar ). An obstetric simulation program promotes a rapid and organized response to these emergent situations. The Obstetric Quality and Safety Team at our hospital decided that obstetric simulations would be the best way to combine emergency drills, multidisciplinary team building, and improved communication. Obstetric emergency simulation drills were conducted at the obstetric units of both Atlantic Health hospitals in 2008. The two sites include a regional perinatal center and a perinatal intensive center. The combined total number of annual deliveries for both sites was 6,300. All simulations utilized the same scenario and were facilitated by the same personnel to provide continuity. Simulation of a patient presenting in hypertensive crisis included at least one primary care provider and two or more nurses. During the simulation experience, the use of antihypertensive and anticonvulsant medication administration was reviewed. Participants included 95% of obstetric nurses, 93% of obstetric hospitalists, and 63.5% of private attending obstetricians and certified nurse midwives at both hospital sites. The objective was to determine if the implementation of obstetric simulations specific to hypertension in pregnancy would have an impact on the care of patients.