Advanced Life Support in Obstetrics (ALSO) and post-partum hemorrhage: a prospective intervention study in Tanzania

Sørensen, Bent; Rasch, Vibeke; Massawe, Siriel; Nyakina, Juma; Elsass, Peter; Nielsen, Birgitte Bruun

doi:10.1111/j.1600-0412.2011.01115.x

Cited by 56 publications

(62 citation statements)

References 18 publications

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“…Emails: laura.walker@curtin.edu.au, ljm56@bigpond.com 1 workforce in Australia can also benefit from centralised courses like ALSO, which promote internationally recognised, evidence-based obstetric emergency skills that are transferable to any workplace. Although the effectiveness of the ALSO course has been evaluated several times in the United States of America (USA) [12][13][14][15] and ALSO outcomes have been measured in a hospital in Tanzania, 16 no other published research evaluating the ALSO course was identified. To this end, the aims of this study were to measure changes in participants' confidence and perceived knowledge to manage specific obstetric situations immediately after completion of an ALSO course in Australia and to reassess six weeks later to determine retention of confidence and perceived knowledge.…”

Section: Introductionmentioning

confidence: 99%

Perceived changes in the knowledge and confidence of doctors and midwives to manage obstetric emergencies following completion of an Advanced Life Support in Obstetrics course in Australia

Walker

Fetherston

McMurray

2013

Aust NZ J Obst Gynaeco

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Background The Advanced Life Support in Obstetrics (ALSO) course is an internationally recognised interprofessional course to support health professionals to develop and maintain the knowledge and skills to manage obstetric emergencies. Aims This study investigated changes in confidence and perceived changes in the knowledge of doctors and midwives to manage specific obstetric emergency situations following completion of an ALSO course in Australia. Methods A prospective repeated‐measures survey design was used to survey 165 course attendees from four Australian states pre‐ and postcourse and at six weeks (n = 101). Data were analysed using a Friedman two‐way repeated‐measures analysis of variance and the Wilcoxon signed rank test. Results There was a significant improvement in confidence and perceived knowledge of the recommended management of all 17 emergency situations immediately postcourse (P < 0.001) and at six weeks postcourse (P < 0.001) when compared to precourse levels for both groups of health professionals. However, a significant decrease in knowledge and confidence for many emergency situations from immediately postcourse to six weeks postcourse (P < 0.05) was also observed in both groups. Conclusions Completion of the Australian ALSO course in Australia has a positive effect on the confidence and perceived knowledge of doctors and midwives to manage obstetric emergencies. However, there needs to be some means of reinforcing the effects of the course for longer term maintenance of knowledge and confidence.

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Section: Introductionmentioning

confidence: 99%

Perceived changes in the knowledge and confidence of doctors and midwives to manage obstetric emergencies following completion of an Advanced Life Support in Obstetrics course in Australia

Walker

Fetherston

McMurray

2013

Aust NZ J Obst Gynaeco

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“…These study results are similar with previous results of a study conducted in Tanzania, which showed a significant decrease in episiotomies and a reduction of incidence of PPH after skilled birth attendants' participation in an ALSO R course. [16] Availability of resources was discussed by the participants to be important to facilitate the application of their newly acquired knowledge and skill into practice. Shortage of skilled birth attendants, particularly midwives, and insufficient materials and equipment were identified by the participants as the main challenges hampering knowledge transfer to midwifery practice.…”

Section: Discussionmentioning

confidence: 99%

“…[16,17] In Rwanda, ALSO R education has been offered to health professionals working in maternity services (midwives, nurses, and physicians) since 2005. Additionally, CPD educational sessions including ALSO R , using a 'train-the-trainer' approach, have recently been conducted by the Maternal, Newborn, and Child Health in Rwanda Project (MNCHR) in the Eastern province of Rwanda.…”

Section: Introductionmentioning

confidence: 99%

Midwives’ experience of participating in the Advanced Life Support in Obstetrics® educational program in Rwanda

Uwajeneza

Babenko-Mould

Evans

et al. 2015

JNEP

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High maternal and newborn mortality rates remain a global health issue. Ninety-nine percent of maternal deaths occur in low and middle income countries and many could be prevented by having more qualified health providers. In 2013, 62% of maternal deaths took place in Sub-Saharan Africa. The Advanced Life Support in Obstetrics (ALSO R ) Educational Program is an internationally recognized continuous professional development course aimed at increasing the knowledge, skills, competence, and confidence of health professionals to manage obstetric emergencies. The purpose of this qualitative descriptive study was to explore midwives' experiences of translating the knowledge and skills acquired from participating in the ALSO R program into their professional practice in Rwanda. A purposive sample of nine midwives participated in one-to-one interviews directed at understanding their experience of implementing their new knowledge and skills into practice. All interviews were audio-recorded and transcribed verbatim. Content analysis was used to illuminate five themes: 1) Improved midwifery practice, 2) Availability of resources, 3) Inter-professional collaboration, 4) Job (dis)satisfaction, and 5) Autonomy for midwifery practice. The findings revealed that although midwives reported increased knowledge, skills and confidence in management of obstetric emergencies, their ability to change practice was often hampered by non-conducive work environments, a shortage of health care providers, and insufficient equipment and materials. These findings can serve to inform ALSO R course module development, midwifery education development, and health human resources policy that can address obstetrical and newborn education needs and health service delivery in Rwanda.

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“…Recently reported research has shown the effectiveness in conferring these management skills for postpartum hemorrhage to maternity care providers in Tanzania [9].…”

Section: Introductionmentioning

confidence: 99%

“…Some research has been done reporting on persistence of simulation-trained skills 1 and 6 months after such teaching, in OB residents, British midwives and OB faculty [8][9][10]. Shoulder dystocia resolution skills of those residents recently trained (with pelvic and fetal manikin beyond their traditional residency training), were demonstrably better than those with traditional residency training [11].…”

Section: Introductionmentioning

confidence: 99%

Comparison Study of ALSO ® Trained and Traditionally Trained OB-GYN and Family Medicine Residents in Shoulder Dystocia

Tullar¹,

True²,

Stowe-Quain³

et al. 2012

TOMEDEDUJ

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Abstract:Introduction: Obstetrics is a high risk specialty. The cephalic presentation vaginal delivery complicated by shoulder dystocia is a medical emergency commonly encountered. This study compares shoulder dystocia resolution educational and manual skills of Obstetrics and Gynecology (OB-GYN) and Family Medicine (FM) residents following completion of Advanced Life Support in Obstetrics (ALSO ® ) trained vs. a group of OB-GYN and FM residents untrained in ALSO but trained in traditional means in a traditional residency to manage shoulder dystocia. Materials and Methods:Shoulder dystocia resolution skills taught in simulation using pelvic and fetal manikins were tested in Family Medicine and OB-GYN residencies who were ALSO ® trained, and they were retested for the purpose of this study 6 months after their training. The same testing, using the same checklist, was done for traditionally trained OB-GYN and Family Medicine residents (who had not been exposed to the ALSO® training) by the same instructor, using the same checklist. Results:The mean score of all (FM & OB-GYN) who had taken the course six months before testing was statistically higher than those in traditional OB-GYN and FM training who had not (p < 0.0001).Discussion/Conclusions: Performance scores of simulation-trained Family Medicine and OB-GYN residents in resolving shoulder dystocia was higher 6 months after training compared to a group of OB-GYN and Family Medicine residents from traditional residencies not trained in shoulder dystocia resolution. This may have implications for patient safety.

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Advanced Life Support in Obstetrics (ALSO) and post-partum hemorrhage: a prospective intervention study in Tanzania

Abstract: A two-day ALSO training course can significantly improve staff performance and reduce the incidence of PPH, at least as evaluated by short-term effects.

Cited by 56 publications

References 18 publications

Perceived changes in the knowledge and confidence of doctors and midwives to manage obstetric emergencies following completion of an Advanced Life Support in Obstetrics course in Australia

Perceived changes in the knowledge and confidence of doctors and midwives to manage obstetric emergencies following completion of an Advanced Life Support in Obstetrics course in Australia

Midwives’ experience of participating in the Advanced Life Support in Obstetrics® educational program in Rwanda

Comparison Study of ALSO ® Trained and Traditionally Trained OB-GYN and Family Medicine Residents in Shoulder Dystocia

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