Multi-professional training for obstetric emergencies in a U.S. hospital over a 7-year interval: an observational study.

Abstract

Birth is less safe than it can be. We adapted the UK-developed PROMPT (PRactical Obstetric Multi-Professional Training) course to local practices and initiated annual training. This observational study used quality assurance data from University of Kansas Hospital 2 years before and 7 years after intervention encompassing 14,309 consecutive deliveries from January 2006 through December 2014. An events/trials approach was applied to changes in proportions over time. PROMPT was associated with progressive decreases in rates (P<0.05) of brachial plexus injury and umbilical artery pH <7.00 exclusive of catastrophic events. Reduced rates (P<0.05) of cesarean section, episiotomy and higher perception of nurse/physician communication were documented. Hypoxic ischemic encephalopathy (HIE) rates declined progressively by >50% (P=NS). These improvements occurred despite younger faculty and higher rates of complicated pregnancies (P<0.05). Estimated health-care costs avoided exceeded annual training costs. Local annual multi-professional training as provided by PROMPT was temporally associated with improved obstetric outcomes.