The Effectiveness of a Pilot Simulation Workshop on Basic Obstetric Emergency Care for Outlying Island General Outpatient Clinic Nurses in HKEC

Abstract Description

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Authors (including presenting author) :

Yip MY(1), Ho HL(1), Lau CM(1), So FY(1), Li OC(1), Hsu LL(1), Cheung PH(2)Cheung K(2), Leung WL(1)

Affiliation :

(1)Department of Obstetrics & Gynaecology, Pamela Youde Nethersole Eastern Hospital (2)Department of Family Medicine & Primary Healthcare, Hong Kong East Cluster

Introduction :

Obstetric emergencies can happen in all clinical settings. Ineffective management of obstetric emergencies contributes significantly to maternal and neonatal morbidity and mortality. Although outlying island general outpatient clinic (GOPC) nurses are not expected to be familiar of obstetric emergency care, they must be able to readily recognize the emergency situations, assess the level of intervention needed, provide appropriate care to prevent deterioration of pregnant woman’s condition, determine the need for activating obstetric emergency responders, and escort the obstetric case to PYNEH by helicopter if needed. Thus, a pilot workshop on basic obstetric emergency care was developed for outlying island GOPC nurses.

Objectives :

To equip nurses working in outlying island GOPC to work as a team to manage basic obstetric emergency appropriately.

Methodology :

It was a cross-sectional study which was conducted from May to June 2018. 30 GOPC nurses participated in the study. Nurses were required to attend lecture and hands-on-skills training on normal vaginal delivery, basic obstetric emergency care and neonatal resuscitation. Then 5 nurses worked as a team to run 2 obstetric simulation scenarios with in-scenario debriefings. The scenarios were focused on the obstetric emergency that may occur in GOPC setting. Pre and post-tests which consisted of 5 multiple choice questions on the basic obstetric knowledge were conducted individually before and after the workshop. Paired t-test was used to analyze the pre and post-test scores.

Result & Outcome :

93.3% of participants were registered nurses and 6.7% of them were registered midwives. The passing score of pre and post-tests was 3 out of 5. 43.3% of participants passed the pre-test with mean score 2.37 (95% CI=2.03-2.7). All of them passed the post-test with mean score 4.47 (95% CI=4.21-4.72). They showed 2.1 increment in post-test score on average (p< 0.001, 95% CI=1.76-2.44). The pilot simulation workshop can strengthen nurses’ knowledge, skills and confidence in managing normal vaginal delivery, basic obstetric emergency and neonatal resuscitation in order to enhance pregnant women’s and their unborn babies’ safety in outpatient setting. Advanced training workshop can be considered for enriching their obstetric learning experiences in the future.