Abstract

A large hospital system in Colorado where 3500 women deliver each year provided 45 simulation sessions for 195 registered nurses, 34 obstetricians and anesthesiologists, and 24 surgical techs. Simulations were provided in situ and included 4 RN's, 1-2 physicians, and 1 surgical tech. Simulations began in a patient room and progressed with transfer and treatment to the operating rooms. Simulations followed INACSL Standards of Best Practice: Simulation(SM). Team objectives included initiating early warning blood loss criteria, coordinate care, demonstrate early crew resource management, closed loop communication, equipment locations, medication management, and blood administration in an acute massive transfusion situation. Electronic medical record abstraction through qualitative chart review pre and post education found neonatal deliveries increased from 1788 to 1790, with an increase of 78 to 82 quantified PPH . The number of patients that requiring only medications increased to 60 from 52, patients that required surgical interventions decreased from 27 to 20, and patients needing transfusions decreased by 50% from 18 to 9. Additionally simulations identified process improvements that included supply location changes, additions to a massive transfusion protocol, and implementation of the Early Blood Loss Intervention protocol. Supportive documentation received from physicians post education stated improvement in team performance during patient actual PPH situations. Barriers included competing organization needs that limited some physicians' involvement, and process differences between hospital sites. interprofessional in situ simulation education is an effective modality to improving patient care outcomes as well as identifying process improvement opportunities by hardwiring early intervention for PPH complications.

Author Details

Laura Wining MSN, CHSE, CAPA, CHPN, Coordinator of Education Programs-Simulation; Tracy D. McGuire, MSN, RNC-HROB, C-EFM, FM, Clinical Education Nurse-Women’s and Children’s Service Line

Sigma Membership

Non-member

Lead Author Affiliation

International Nursing Association for Clinical Simulation and Learning (INACSL)

Type

Presentation

Format Type

Text-based Document

Study Design/Type

N/A

Research Approach

N/A

Keywords:

Simulation, Post Partum Hemmorhage, Interprofessional, Patient Outcomes

Conference Name

INACSL Conference 2017

Conference Host

INACSL

Conference Location

Washington, D.C., USA

Conference Year

2017

Rights Holder

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All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

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Implementation of a high fidelity post partum hemmorhage simulation for an acute care multisite, interprofessional women and childrens service line improves patient care outcomes

Washington, D.C., USA

A large hospital system in Colorado where 3500 women deliver each year provided 45 simulation sessions for 195 registered nurses, 34 obstetricians and anesthesiologists, and 24 surgical techs. Simulations were provided in situ and included 4 RN's, 1-2 physicians, and 1 surgical tech. Simulations began in a patient room and progressed with transfer and treatment to the operating rooms. Simulations followed INACSL Standards of Best Practice: Simulation(SM). Team objectives included initiating early warning blood loss criteria, coordinate care, demonstrate early crew resource management, closed loop communication, equipment locations, medication management, and blood administration in an acute massive transfusion situation. Electronic medical record abstraction through qualitative chart review pre and post education found neonatal deliveries increased from 1788 to 1790, with an increase of 78 to 82 quantified PPH . The number of patients that requiring only medications increased to 60 from 52, patients that required surgical interventions decreased from 27 to 20, and patients needing transfusions decreased by 50% from 18 to 9. Additionally simulations identified process improvements that included supply location changes, additions to a massive transfusion protocol, and implementation of the Early Blood Loss Intervention protocol. Supportive documentation received from physicians post education stated improvement in team performance during patient actual PPH situations. Barriers included competing organization needs that limited some physicians' involvement, and process differences between hospital sites. interprofessional in situ simulation education is an effective modality to improving patient care outcomes as well as identifying process improvement opportunities by hardwiring early intervention for PPH complications.