Noblot Edouard, Raia-Barjat Tiphaine, Lajeunesse Cecile, Trombert Béatrice, Weiss Stéphanie, Colombié Maud, Chauleur Céline
Obstetrics and Gynecology Department, Saint Etienne University Hospital, Saint-Priest-en-Jarez, France; Jean Monnet University, Faculty of Medicine, Saint Etienne, France.
Obstetrics and Gynecology Department, Saint Etienne University Hospital, Saint-Priest-en-Jarez, France; Jean Monnet University, Faculty of Medicine, Saint Etienne, France; EA 3065 Thrombosis Research Group, Jean Monnet University, Saint Etienne, France.
Eur J Obstet Gynecol Reprod Biol. 2015 Jun;189:101-5. doi: 10.1016/j.ejogrb.2015.03.019. Epub 2015 Apr 10.
To evaluate the effectiveness of an interdisciplinary team training program based on simulated scenarios and focusing on two obstetrical emergency situations: shoulder dystocia and complicated breech vaginal delivery (CBVD). These situations are rare, so there are few opportunities for real-life training, yet their competent and efficient management is crucial to minimizing the risks to mother and child.
The target population for training comprised the 450 professionals working in the French regional perinatal care network ELENA. An expert committee defined the topics for the training program, selected the simulated scenarios and developed the evaluation grids. The training sessions were conducted by two qualified and experienced professionals in each maternity unit. They comprised a theoretical introduction followed by practical exercises in management of simulated emergency situations by the participant teams, with the aid of a mannequin. Each team completed the exercises twice, their performances being filmed, reviewed and evaluated in each case.
The training sessions took place over 9 months between September 2012 and June 2013. A total of 298 professionals (obstetricians, residents in obstetrics, midwives and nursery nurses) were trained, representing 75% of the staff working in the ELENA perinatal care network. The results showed substantial and significant increases in the overall scores for management of the two emergency situations (from 74.5% to 91.4% for shoulder dystocia [p<0.0001], and from 67.2% to 88.4% [p<0.0001] for CBVD) as well as in the scores for all the specific areas of expertise assessed: safety, know-how, technique, team communication and communication with the patient.
This study demonstrated the value of multidisciplinary team training for obstetric emergencies, encouraging the ELENA perinatal care network to implement an annual training program for its staff. Over and above our experience, the future establishment of a national education program to optimize the management of obstetric emergencies seems to be essential.
评估基于模拟场景且聚焦两种产科紧急情况（肩难产和复杂臀位阴道分娩（CBVD））的跨学科团队培训项目的有效性。这些情况较为罕见，因此现实生活中的培训机会很少，但对其进行有效管理对于将母婴风险降至最低至关重要。
培训的目标人群包括在法国地区围产期护理网络ELENA工作的450名专业人员。一个专家委员会确定了培训项目的主题，选择了模拟场景并制定了评估标准。培训课程由每个产科单位的两名合格且经验丰富的专业人员进行。课程包括理论介绍，随后是参与团队借助人体模型对模拟紧急情况进行管理的实践练习。每个团队完成练习两次，每次练习的表现都进行拍摄、审查和评估。
培训课程于2012年9月至2013年6月期间进行了9个月。共有298名专业人员（产科医生、产科住院医师、助产士和新生儿护士）接受了培训，占ELENA围产期护理网络工作人员的75%。结果显示，两种紧急情况管理的总体得分大幅显著提高（肩难产从74.5%提高到91.4%[p<0.0001]，CBVD从67.2%提高到88.4%[p<0.0001]），以及所有评估的专业特定领域的得分也有所提高：安全性、专业技能、技术、团队沟通以及与患者的沟通。
本研究证明了多学科团队培训对产科紧急情况的价值，鼓励ELENA围产期护理网络为其工作人员实施年度培训项目。除了我们的经验之外，未来建立全国性教育项目以优化产科紧急情况的管理似乎至关重要。
