Lawson Wyeth, Smith Michael, McCue Brigid
Department of Obstetrics and Gynecology, Ochsner Clinic Foundation, New Orleans, LA.
Department of Emergency Medicine, Ochsner Clinic Foundation, New Orleans, LA.
Ochsner J. 2020 Winter;20(4):394-399. doi: 10.31486/toj.20.0014.
Simulation training improves the response to obstetric emergencies. We review the current literature regarding simulation training for provider education, team training, and obstetric outcomes and describe the implementation of a multidisciplinary obstetric simulation program. A review of literature available at PubMed reveals many studies focused on provider education but few studies detailing the direct impact on patients. We review simulation reports that demonstrate improved clinical outcomes after obstetric emergencies-such as shoulder dystocia, postpartum hemorrhage, delivery of the second twin, operative vaginal delivery, urgent cesarean delivery, and neonatal resuscitation-as these studies formed the basis of the Ochsner Obstetrics and Gynecology Simulation Program in New Orleans, LA. We discuss the 3 principal simulation formats at Ochsner: a half-day course at the simulation training center, in-situ simulation on clinical care floors, and just-in-time training in the classroom. We also present detailed examples of simulation scenarios to assist others in creating a robust simulation program to ensure staff and providers are well trained to respond to obstetric emergencies. The Ochsner Obstetrics and Gynecology Simulation Program was formulated on published literature and incorporates a variety of clinical settings, scenarios, and approaches to improve educational opportunities and response to obstetric emergencies.
模拟培训可提高对产科急症的应对能力。我们回顾了当前关于模拟培训在医护人员教育、团队培训及产科结局方面的文献，并描述了一个多学科产科模拟项目的实施情况。对PubMed上现有文献的回顾显示，许多研究聚焦于医护人员教育，但很少有研究详述其对患者的直接影响。我们回顾了一些模拟报告，这些报告表明在诸如肩难产、产后出血、双胎之二分娩、产钳助产、紧急剖宫产及新生儿复苏等产科急症后临床结局得到了改善，因为这些研究构成了路易斯安那州新奥尔良市奥施纳妇产科模拟项目的基础。我们讨论了奥施纳的三种主要模拟形式：在模拟培训中心举办的半天课程、在临床护理楼层进行的现场模拟以及在教室开展的即时培训。我们还给出了模拟场景的详细示例，以帮助其他人创建一个强大的模拟项目，确保工作人员和医护人员得到充分培训以应对产科急症。奥施纳妇产科模拟项目是根据已发表的文献制定的，融合了各种临床场景、情况及方法，以增加教育机会并提高对产科急症的应对能力。
