Outcomes associated with introduction of a shoulder dystocia protocol

Grobman, William A.; Miller, Dick R.; Burke, Carol A.; Hornbogen, Abby; Tam, Karen; Costello, Robert

doi:10.1016/j.ajog.2011.05.002

Cited by 85 publications

(36 citation statements)

References 11 publications

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“…Training for SD is a good example of the possibly conflicting effects of the use of different training mannequins: there are some reports of improvements in neonatal outcomes after training [33, 35,36,47], whereas other training has been associated with no change in outcomes [16], or even an increase in poor neonatal outcomes, after training had been introduced [18]. One of the important differences in the training between these programmes was the training model used.…”

Section: Myth 7: All Training Models and Mannequins Are Usefulmentioning

confidence: 98%

Myths and realities of training in obstetric emergencies

Draycott

Collins

Crofts

et al. 2015

Best Practice & Research Clinical Obstetrics & Gynaecol

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Section: Myth 7: All Training Models and Mannequins Are Usefulmentioning

confidence: 98%

Myths and realities of training in obstetric emergencies

Draycott

Collins

Crofts

et al. 2015

Best Practice & Research Clinical Obstetrics & Gynaecol

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“…There are a number of publications investigating the incidence of BPI pre-and post-training intervention, 8,[19][20][21] but they are difficult to compare because the incidence is expressed with different denominators. We suggest that this could usefully be standardised: the expression and publication of permanent brachial plexus injury rate as (i) the proportion of cases of shoulder dystocia, (ii) the proportion of vaginal births, and (iii) the proportion of total births.…”

Section: Interpretation (In Light Of Other Evidence)mentioning

confidence: 99%

“…Some shoulder dystocia training has been demonstrated to improve knowledge, 12 confidence 13 and management of simulated shoulder dystocia. [14][15][16][17] However, the effect of training on perinatal outcomes has been conflicting; there are reports of improvements after training, 8,18,19 whereas other training has been associated with no change in outcomes, 20 or even an increase in poor neonatal outcomes after training had been introduced. 21 Practice does not make perfect if it is the wrong practice.…”

Section: Introductionmentioning

confidence: 99%

Prevention of brachial plexus injury—12 years of shoulder dystocia training: an interrupted time‐series study

Crofts

Lenguerrand

Bentham

et al. 2015

BJOG

152

143

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Objective To investigate management and outcomes of incidences of shoulder dystocia in the 12 years following the introduction of an obstetric emergencies training programme.Design Interrupted time-series study comparing management and neonatal outcome of births complicated by shoulder dystocia over three 4-year periods: (i) Pre-training (1996-99) Method A bi-monthly multi-professional 1-day intrapartum emergencies training course, that included a 30-minute practical session on shoulder dystocia management, commenced in 2000.Main Outcomes Neonatal morbidity (brachial plexus injury, humeral fracture, clavicular fracture, 5-minute Apgar score <7) and documented management of shoulder dystocia (resolution manoeuvres performed, traction applied, head-to-body delivery interval).Results Compliance with national guidance improved with continued training. At least one recognised resolution manoeuvre was used in 99.8% (561/562) of cases of shoulder dystocia in the late training period, demonstrating a continued improvement from 46.3% (150/324, P < 0.001) pre-training, and 92% (241/262, P < 0.001) in the early training period. In parallel there was reduction in the brachial plexus injury at birth (24/324 [7.4%, P < 0.01], pre-training, 6/262 [2.3%] early training, and 7/562 [1.3%] late training.Conclusions There are significant benefits to long-term, embedded training programmes with improvements in both management and outcomes. A decade after the introduction of training there were no cases of brachial plexus injury lasting over 12 months in 562 cases of shoulder dystocia.

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“…28 Team behaviors (T1) improved after simulation-based team training (SBTT) in interdisciplinary trauma care, 29,30 adult and neonatal resuscitation, 31,32 and obstetric emergency training. 33 Care delivery, measured using surrogate markers such as the time to complete the primary survey, intubation, defibrillation, transport to CT scanner, or degree of adherence to clinical care guidelines (ACLS) also improved with SBTT in both simulation (T1) 29 -31 and clinical care (T2) environments. 29,30 Few studies demonstrate improved patient outcomes (T3) with SBTT.…”

Section: Teamwork Trainingmentioning

confidence: 99%

“…18 Neonatal injury rates have also been reduced using both procedural and team skills training. 19,33 Environmental assessment Simulation can be used to identify physical plant deficiencies in the clinical arena. Environmental barriers to high-quality health care can be attributed to medication, equipment, or system/resource issues.…”

Section: Teamwork Trainingmentioning

confidence: 99%