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适宜分娩项目:模拟培训对增加巴西医院阴道分娩的影响。

Appropriate Delivery Project: Impact of Simulation Training on the Increase in Vaginal Births in Hospitals in Brazil.

机构信息

Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.

出版信息

Einstein (Sao Paulo). 2024 Aug 9;22:eAO0783. doi: 10.31744/einstein_journal/2024AO0783. eCollection 2024.

Abstract

OBJECTIVE

This study aimed to analyze the relationship between the participation of professionals in simulation-based training and an increase in the rate of vaginal deliveries.

METHODS

This retrospective observational study analyzed professionals' participation in high-fidelity simulation training during the pilot phase of the Appropriate Delivery Project, spanning from May 21, 2015 to May 21, 2016, along with the rates of vaginal deliveries across various hospitals. Data for participation by nurses and physicians were examined using a gamma distribution model to discern the predictors influencing the changes in the percentage of vaginal births.

RESULTS

Data from 27 hospitals involved in the project were analyzed. A total of 339 healthcare professionals, including 147 nurses and 192 doctors, underwent the simulation-based training. During the pilot test, the percentage of vaginal births increased from 27.8% to 36.1%, which further increased to 39.8% in the post-intervention period, particularly when the participation rate of nurses exceeded the median.

CONCLUSION

This study suggests that simulation-based training is a valuable strategy for achieving positive changes in obstetric practice, specifically an increase in the rate of vaginal births. These findings underscore the potential advantages of incorporating simulation training into improvement initiatives, as evidenced by the correlation between higher training adoption rates and substantial and sustained enhancements in vaginal birth rates.

摘要

目的

本研究旨在分析专业人员参与基于模拟的培训与阴道分娩率提高之间的关系。

方法

本回顾性观察研究分析了 2015 年 5 月 21 日至 2016 年 5 月 21 日期间适当分娩项目试点阶段专业人员参与高保真模拟培训的情况,以及各医院的阴道分娩率。使用伽马分布模型分析护士和医生的参与数据,以确定影响阴道分娩百分比变化的预测因素。

结果

分析了参与该项目的 27 家医院的数据。共有 339 名医护人员参加了基于模拟的培训,其中包括 147 名护士和 192 名医生。在试点测试期间,阴道分娩率从 27.8%增加到 36.1%,在干预后期间进一步增加到 39.8%,特别是当护士的参与率超过中位数时。

结论

本研究表明,基于模拟的培训是改善产科实践的一种有价值的策略,特别是可以提高阴道分娩率。这些发现强调了将模拟培训纳入改进计划的潜在优势,因为更高的培训采用率与阴道分娩率的显著和持续提高之间存在相关性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a3f5/11319025/766ab7f4efa2/2317-6385-eins-22-eAO0783-gf01.jpg

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