Assessment of a multiprofessional training programme by in situ simulation in the maternity units of the Pays de Loire regional perinatal network

Dochez, Vincent; Beringue, F; Legendre, Guillaume; Jeanneteau, Pauline; Rolland, Delphine; Coutin, Anne-Sophie; Collin, Rozenn; Boulvais, Estelle; Malo, Laëtitia; Chupin, Anne-Marie; Cousin, B; Flamant, Cyrille; Winer, Norbert

doi:10.1016/j.jogoh.2021.102107

Cited by 5 publications

(1 citation statement)

References 20 publications

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“…1. [27] Frankreich CRM Crew Resource Management, CTG Kardiotokogramm, EC Erythroztenkonzentrat, MOET ® Managing obstetric emergencies and trauma, Noelle ® Geburtssimulator der Firma Gaumard Scientific, Canada, PPH postpartale Hämorrhagie, PROMPT ® PRactical Obstetric Multi-Professional Training, RCT "randomized controlled trial", TeamSTEPPS Team Strategies&Tools to Enhance Performance & Patient Safety, TOA technische Operatonsassistenzperson(en) Die wichtigsten einzelnen Notfallszenarien werden weiter unten ausgeführt.…”

Section: Historischer Hintergrundunclassified

Interdisciplinary training programs in obstetrics

et al. 2023

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ZusammenfassungEine geburtshilfliche Simulation gibt den Teilnehmenden die Möglichkeit, realitätsnah klinische Szenarien durchzuspielen und sowohl technische als auch „non technical skills“ im Team zu trainieren. Die anschließende Nachbesprechung evaluiert die Simulation. Mit zunehmender Verunsicherung im Ausführen geburtshilflicher Manöver durch fehlende praktische Erfahrung und Angst vor Verantwortung können Aufbau und Erhalt von Simulationstrainings auch einen attraktiven neuen Weg darstellen, das Interesse für die Geburtshilfe zu stärken und zu fördern. Bisher zeigten sich positive Ergebnisse in der Zufriedenheit der Teilnehmenden, in der Gewinnung von Sicherheit beim Durchführen der Manöver, in der Verbesserung der interdisziplinären Teamarbeit und im klinischen Outcome. Die Durchführung der Simulationen ist kosten- und zeitintensiv; Teamwork und Kommunikation lassen sich nur im interdisziplinären und interprofessionellen Setting (Hebammen, Geburtshelfer/innen, Anästhesisten/innen) trainieren. Grundvoraussetzungen der Simulation sind Unterstützung durch die Klinikleitung, Motivation der Teilnehmenden und in Debriefingverfahren geschulte Trainer.

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Section: Historischer Hintergrundunclassified

Interdisciplinary training programs in obstetrics

et al. 2023

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Consent for interventions during childbirth: A national population‐based study

Jacques,

Chantry,

Evrard

et al. 2024

Intl J Gynecology & Obste

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ObjectiveTo assess the frequency and determinants of medical interventions during childbirth without women's consent at the population level.MethodsThe nationwide cross‐sectional Enquête Nationale Périnatale 2021 provided a representative sample of women who delivered in metropolitan France with a 2‐month postpartum follow‐up (n = 7394). Rates and 95% confidence intervals (CI) of interventions during childbirth (oxytocin administration, episiotomy or emergency cesarean section) without consent were calculated. Associations with maternal, obstetric, and organizational characteristics were assessed using robust variance Poisson regressions, after multiple imputation for missing covariates, and weighted to account for 2‐month attrition.ResultsWomen reporting failure to seek consent were 44.7% (CI: 42.6–47.0) for oxytocin administration, 60.2% (CI: 55.4–65.0) for episiotomy, and 36.6% (CI: 33.3–40.0) for emergency cesarean birth. Lack of consent for oxytocin was associated with maternal birth abroad (adjusted prevalence ratio [aPR] 1.20; 95% CI: 1.06–1.36), low education level, and increased cervical dilation at oxytocin initiation, whereas women with a birth plan reported less frequently lack of consent (aPR 0.79; 95% CI: 0.68–0.92). Delivery assisted by an obstetrician was more often associated with lack of consent for episiotomy (aPR 1.46; 95% CI: 1.11–1.94 for spontaneous delivery and aPR 1.39; 95% CI: 1.13–1.72 for instrumental delivery, reference: spontaneous delivery with a midwife). Cesarean for fetal distress was associated with failure to ask for consent for emergency cesarean delivery (aPR 1.58; 95% CI: 1.28–1.96).ConclusionWomen frequently reported that perinatal professionals failed to seek consent for interventions during childbirth. Reorganization of care, particularly in emergency contexts, training focusing on adequate communication and promotion of birth plans are necessary to improve women's involvement in decision making during childbirth.

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