Changes in self‐efficacy, collective efficacy and patient outcome following interprofessional simulation training on postpartum haemorrhage

Abstract

Aims and objectives. To examine whether interprofessional simulation training on management of postpartum haemorrhage enhances self-efficacy and collective efficacy and reduces the blood transfusion rate after birth. Background. Postpartum haemorrhage is a leading cause of maternal morbidity and mortality worldwide, although it is preventable in most cases. Interprofessional simulation training might help improve the competence of health professionals dealing with postpartum haemorrhage, and more information is needed to determine its potential. Design. Multimethod, quasi-experimental, pre-post intervention design. Methods. Interprofessional simulation training on postpartum haemorrhage was implemented for midwives, obstetricians and auxiliary nurses in a university hospital. Training included realistic scenarios and debriefing, and a measurement scale for perceived postpartum haemorrhage-specific self-efficacy, and collective efficacy was developed and implemented. Red blood cell transfusion was used as the dependent variable for improved patient outcome pre-post intervention. Results. Self-efficacy and collective efficacy levels were significantly increased after training. The overall red blood cell transfusion rate did not change, but there was a significant reduction in the use of ≥5 units of blood products related to severe bleeding after birth. Conclusion. The study contributes to new knowledge on how simulation training through mastery and vicarious experiences, verbal persuasion and psychophysiological state might enhance postpartum haemorrhage-specific self-efficacy and collective efficacy levels and thereby predict team performance. The significant reduction in severe postpartum haemorrhage after training, indicated by reduction in ≥5 units of blood transfusions, corresponds well with the improvement in collective efficacy, and might reflect the emphasis on collective efforts to counteract severe cases of postpartum haemorrhage.What does this paper contribute to the wider global clinical community?• Research supports future team training on postpartum haemorrhage. Faculty should be aware of the importance of mastery and vicarious experiences, verbal persuasion and psychophysiological state for increased efficacy.• Simulation training can prepare staff to handle clinical emergencies and follow-up after experienced emergencies. Full participation of all staff is likely to be crucial for improved patient outcomes.• Future research should evaluate interprofessional simulation training programmes to identify the crucial factors for improved outcomes related to prevention, identification and treatment of postpartum haemorrhage. Relevance to clinical practice. Interprofessional simulation training in teams may contribute to enhanced prevention and management of postpartum haemorrhage, shown by a significant increase in perceived efficacy levels combined with an indicated reduction of severe postpartum haemorrhage after training.

Impact of multi-professional, scenario-based training on postpartum hemorrhage in Tanzania: a quasi-experimental, pre- vs. post-intervention study

“…The prevalence of blood transfusions at KCMC from 3.2 to 1.7% pre-post training corresponds with findings from a retrospective study on similar simulation training in Norway, where the prevalence of blood transfusions dropped from 3.4 to 2% after training [ 11 ]. Another Norwegian study on simulation training showed a transfusion rate pre-post training of 4.6 and 4.6% respectively [ 44 ]. The reported overall maternal transfusion rate at KCMC was according to Macheku et al 5.7% during a period of 10 years, including antenatal hemorrhage counting for 74%, PPH for 26% of the incidents [ 12 ].…”

Coordinated responses of academic medical centres to pandemics: Sustaining medical education during COVID-19

“…The encounters were recorded for asynchronous moderation with a different examiner. Last, examinations involving all three stakeholders (candidate, patient, examiner) were modified to minimise patient participation These were achieved using task-trainers or simulations with mannequins and hybrid simulations (Egenberg et al 2017) or simulated patients. Where patient participation was crucial, candidates were instructed to follow prevailing infection control guidelines with the use of PPE during the assessment.…”

Association of the Nurse Work Environment, Collective Efficacy, and Missed Care

“…In a correlational study, Lee and Ko (2010) found that collective efficacy had a small but significant association with reduced error in nursing performance among a sample of Korean hospital nurses. One collective efficacy interventions among hospital staff was associated with better patient outcomes (Egenberg et al, 2016). Among nursing students, an interprofessional education intervention was associated with greater perceptions of collective efficacy (Wong et al, 2017).…”