Video analysis for the evaluation of vaginal births: a prospective observational study

Abstract

AIMS OF THE STUDY Video documentation is nowadays well established in many fields of medicine, but mostly in unreal situations such as simulation training. We here present the application of video for teaching and learning purposes during the birth process. The aim of video documentation during labour is to provide an observational tool for obstetric care by midwives and obstetricians, with the opportunity for evaluation and education afterwards, especially in absence of the woman in labour and her family. METHODS Between February 2015 and June 2017, we conducted a prospective observational study on women aged over 18 years with singleton pregnancies with vertex presentation at term, who gave birth vaginally in the labour ward at the Division of Obstetrics of the University Hospital of Zurich. The end of birth (crowning of the head and fetal extraction) with the manual actions and manoeuvers performed was recorded on video in 100 births. Procedures were analysed afterwards by a senior consultant and evaluated with the staff involved. RESULTS We found frequent notable omissions during vaginal deliveries, concerning technical and nontechnical skills. Those aspects included inappropriate aseptic technique (e.g., no sterile underlay or sterile gloves), improper fetal head slowdown during expulsion, lack of visualisation of the perineum during fetal extraction/expulsion, lack of hip, shoulder and arm guiding while extracting the fetus, inappropriate episiotomy technique (wrong handling of the scissors, cutting angle too steep) and improper communication between the woman giving birth and the staff. During vacuum extractions, incorrect positioning of the cup, and inappropriate direction of pulling and handling of the cup were recorded. CONCLUSIONS Video analysis of obstetric procedures in the labour ward is an easily applicable and very useful tool for teaching and learning purposes. It contributes to showing and improving the quality of procedures and the interactions of the staff and can be used for staff evaluation. ​ Registered at ClinicalTrials.gov (registration number NCT02295904)

Tecnologias Educativas Para Promoção Do Parto Seguro

“…No que tange as tecnologias utilizadas, foram identificados: vídeos educacionais 14,15,16,17 ; software e cartilha educacional 18,19 ; manual educativo para acompanhantes 20 ; intervenção educacional online 21 ; folheto informativo ilustrado 22 ; intervenção baseada em SMS 23,24 e aplicativos móveis 25,26 . AND (((((((((((((((…”

Healthcare professionals’ perception of safety culture and the Operating Room (OR) Black Box technology before clinical implementation: a cross-sectional survey

“…Healthcare professionals may have differing perspectives on these types of initiatives 11. Reluctance may be a result of privacy concerns or related to impostor phenomenon,15 which is a chronic feeling of self-doubt and the fear of being discovered as an intellectual fraud is known in the medical world but not well studied in the operation room 7 8 13 15–18. Imposter phenomenon, or syndrome as some refer to it, occurs when high-achieving individuals have a pervasive sense of self-doubt combined with fear of being exposed as a fraud, this despite objective measures of success.…”