Mbachu Ikechukwu I, Udigwe Gerald O, Ezeama Chukwuemeka O, Eleje George U, Eke Ahizechukwu C
Department of Obstetrics and Gynecology, Nnamdi Azikiwe University, Nnewi, Nigeria.
Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Johns Hopkins Medicine, Baltimore, MD, USA.
Int J Gynaecol Obstet. 2017 Jun;137(3):345-349. doi: 10.1002/ijgo.12133. Epub 2017 Mar 31.
To determine the effect of on-site training on the accuracy of blood loss estimation in a simulated obstetrics environment.
In a tertiary hospital in Nigeria, clinical scenarios were created in April 2013 using known blood volumes in an objective structured clinical examination fashion. Doctors and nurses who worked in the obstetrics unit observed and recorded the blood volume at different clinical stations (first study stage). Subsequently, the actual amount of blood was revealed, followed by on-site training on the volume capacities of the study instruments. Three weeks later, the second stage of the study was performed like the first stage but using different amounts of blood for all stations. The differences in the mean errors of blood loss estimation between the two stages were determined.
The analysis included 144 healthcare providers who completed both stages of the study. There were significant differences in the mean error of blood loss estimation before and after the training session for the following stations: delivery bed (P<0.001), sanitary pad 1 (P=0.001), sanitary pad 2 (P=0.001), delivery pad (P=0.001), floor (P<0.001), and laparotomy pad (P=0.001).
Periodic education by simulation using clinical scenarios could improve the accuracy of visual blood loss estimation.
确定在模拟产科环境中现场培训对失血估计准确性的影响。
2013年4月，在尼日利亚一家三级医院，以客观结构化临床考试的方式，利用已知血量创建临床场景。产科病房的医生和护士在不同临床站点观察并记录血量（第一研究阶段）。随后，公布实际出血量，接着就研究器械的容量进行现场培训。三周后，研究的第二阶段按照第一阶段的方式进行，但所有站点使用不同量的血液。确定两个阶段之间失血估计平均误差的差异。
分析纳入了完成研究两个阶段的144名医疗服务提供者。以下站点在培训前后失血估计平均误差存在显著差异：产床（P<0.001）、卫生巾1（P=0.001）、卫生巾2（P=0.001）、分娩垫（P=0.001）、地面（P<0.001）和剖腹术垫（P=0.001）。
通过使用临床场景进行模拟的定期教育可提高目测失血估计的准确性。
