Pattern and degree of forces applied during simulation of shoulder dystocia

Crofts, Joanna F.; Ellis, Denise; James, Mark; Hunt, Linda; Fox, Robert; Draycott, Timothy

doi:10.1016/j.ajog.2007.03.038

Cited by 38 publications

(28 citation statements)

References 13 publications

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“…Ten of the papers were related to the Simulation and Fire-drill Evaluation (SaFE) study and were treated as one intervention [19][20][21][22][23][24][25][26][27][28]. Two articles reporting on the Programa de Rescate Obstétrico y Neonatal: Tratamiento Óptimo y Oportuno (PRONTO) trial were included (the pilot study and some of the first results pertaining to changes after the second training module) [29,30].…”

Section: Synopsis Of Peer-reviewed Articles Included In the Reviewmentioning

confidence: 99%

“…Thirteen studies had been conducted in [19][20][21][22][23][24][25][26][27][28] 6 DH (L2&L3) -HIC 10 RCT 2a,b,c 3b NHS Foundation Trust, Liverpool, UK [44,45] --HIC 1 Before-after 4b,c Victoria, Australia [46] 7 [48] --LMIC 1 Before-after 1 2b −−− −−− Sub-Saharan Africa (7 countries) [49] --LMIC 1 Before-after 1 2b,c −−− −−− Somaliland, Somalia [50] 3 8 LMIC 1 Before-after 1 2b,c 3a 4b Making it Happen, Bangladesh & India [52] 4 DH (Bangl.) [54] 3 DH; 3 FH 40 LMIC 1 Quasi-experimental 3c CRM based National study, US [58] 15 -HIC 1 RCT 4c Beth Israel Deaconness Medical Center, US [59] 1 TTH -HIC 1 Before-after 2a 4b,c Perinatal Safety Initiative, US [60] 1 TH -HIC 1 Before-after 3a 4b,c Rhode Island Hospital, US [61] 1 -HIC 1 Before-after 4b,c Geneva University Hospital, Switzerland [63] 1 TTH -HIC 1 Before-after 1 2a 3a TeamSTEPPS, US [18] 3 CH -HIC 1 RCT 2a 4c OBCTT, Southeast US [62] 1 TTH -HIC 1 Quasi-experimental before-after 1 2a,b,c −−− −−− OTHER CEmONC, Tanzania [17] 1 DH LMIC 1 Before-after 3c Copenhagen University Hospital, Denmark [64] 1 TTH -HIC 1 Before-after 1 2a,b 3a 4b University of Oporto, Portugal [65] 1 TTH -HIC 1 Before-after 1 2b 3a * In progress -abstracts not included [31,32] DH = district hospital L1 = level 1 −−− = studies not going beyond Kirkpatrick level 2 RH = referral hospital L2 = level 2 (secondary/regional) FH = field hospital TH = tertiary hospital/medical centre L3 = level 3 (tertiary) CH = community hospital TTH = tertiary and teaching hospital included in the studies spans the whole spectrum from tertiary teaching hospitals to community-and field hospitals.…”

Section: Synopsis Of Peer-reviewed Articles Included In the Reviewmentioning

confidence: 99%

“…• PRactical Obstetric Multi-Professional Training (PROMPT) [19][20][21][22][23][24][25][26][27][28][33][34][35][43][44][45][46]; There were also reports on three locally developed 'in-house' training programmes offered in Tanzania, Denmark and Portugal respectively [17,64,65]. The basic and comprehensive emergency obstetric and neonatal care (BEmONC and CeMONC) training run in many low income countries is often based on the World Health Organization (WHO) training reference manuals [66,67].…”

Section: Synopsis Of Peer-reviewed Articles Included In the Reviewmentioning

confidence: 99%

See 2 more Smart Citations

What is the impact of multi-professional emergency obstetric and neonatal care training?

Bergh

Baloyi

Pattinson

2015

Best Practice & Research Clinical Obstetrics & Gynaecol

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This paper reviews evidence regarding change in healthcare-provider behaviour and maternal and neonatal outcomes as a result of emergency obstetric and neonatal care (EmONC) training. A refined version of the Kirkpatrick classification for programme evaluation was used to focus on change in efficiency and impact of training (levels 3 and 4). Twenty-three studies were reviewed -5 randomised controlled trials, 2 quasi-experimental studies and 16 before-and-after observational studies. Training programmes had all been developed in highincome countries and adapted for use in low-and middle-income countries. Nine studies reported on behaviour change and 13 on process and patient outcomes. Most showed positive results. Every maternity unit should provide EmONC teamwork training, mandatory for all healthcare providers. The challenges are: scaling up such training to all institutions; sustaining regular in-service training; integrating training into institutional and health-system patient-safety initiatives; and 'thinking-out-of-the-box' in evaluation research.

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Section: Synopsis Of Peer-reviewed Articles Included In the Reviewmentioning

confidence: 99%

Section: Synopsis Of Peer-reviewed Articles Included In the Reviewmentioning

confidence: 99%

Section: Synopsis Of Peer-reviewed Articles Included In the Reviewmentioning

confidence: 99%

See 1 more Smart Citation

What is the impact of multi-professional emergency obstetric and neonatal care training?

Bergh

Baloyi

Pattinson

2015

Best Practice & Research Clinical Obstetrics & Gynaecol

View full text Add to dashboard Cite

show abstract

“…Every training day held since 2000 has included a 30-minute practical session on shoulder dystocia management using the PROMPT Birthing Trainer (Limbs and Things Ltd, Bristol, UK) and incorporating lessons from previous simulation-based studies. 3,15,[23][24][25] Each session is facilitated by a midwife and/or an obstetrician and attended by a multi-professional team of five to eight members of staff. At the start of each session the trainers demonstrate the bony impaction of shoulder dystocia using the mannequin with the abdominal skin removed and discuss the importance of routine traction 'do not pull hard, do not pull quickly and do not pull down'.…”

Section: Methodsmentioning

confidence: 99%

Prevention of brachial plexus injury—12 years of shoulder dystocia training: an interrupted time‐series study

Crofts

Lenguerrand

Bentham

et al. 2015

BJOG

152

143

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Objective To investigate management and outcomes of incidences of shoulder dystocia in the 12 years following the introduction of an obstetric emergencies training programme.Design Interrupted time-series study comparing management and neonatal outcome of births complicated by shoulder dystocia over three 4-year periods: (i) Pre-training (1996-99) Method A bi-monthly multi-professional 1-day intrapartum emergencies training course, that included a 30-minute practical session on shoulder dystocia management, commenced in 2000.Main Outcomes Neonatal morbidity (brachial plexus injury, humeral fracture, clavicular fracture, 5-minute Apgar score <7) and documented management of shoulder dystocia (resolution manoeuvres performed, traction applied, head-to-body delivery interval).Results Compliance with national guidance improved with continued training. At least one recognised resolution manoeuvre was used in 99.8% (561/562) of cases of shoulder dystocia in the late training period, demonstrating a continued improvement from 46.3% (150/324, P < 0.001) pre-training, and 92% (241/262, P < 0.001) in the early training period. In parallel there was reduction in the brachial plexus injury at birth (24/324 [7.4%, P < 0.01], pre-training, 6/262 [2.3%] early training, and 7/562 [1.3%] late training.Conclusions There are significant benefits to long-term, embedded training programmes with improvements in both management and outcomes. A decade after the introduction of training there were no cases of brachial plexus injury lasting over 12 months in 562 cases of shoulder dystocia.

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“…Dystocia-induced OBPI has been a focus of much research; dystocia is mechanically distinct, correlating with degree of neurological impairment, 32 permanent impairment, 50 and indication for nerve repair. 54 Awareness of and dedicated training for dystocia maneuvers 20,56 are reported to decrease the incidence of both overall and "permanent" OBPI in practice. 24 …”

Section: Risk Factorsmentioning

confidence: 99%

Obstetrical brachial plexus injury: burden in a publicly funded, universal healthcare system

Coroneos¹,

Voineskos²,

Coroneos

et al. 2016

PED

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OBJECT The aim of this study was to determine the volume and timing of referrals for obstetrical brachial plexus injury (OBPI) to multidisciplinary centers in a national demographic sample. Secondarily, we aimed to measure the incidence and risk factors for OBPI in the sample. The burden of OBPI has not been investigated in a publicly funded system, and the timing and volume of referrals to multidisciplinary centers are unknown. The incidence and risk factors for OBPI have not been established in Canada. METHODS This is a retrospective cohort study. The authors used a demographic sample of all infants born in Canada, capturing all children born in a publicly funded, universal healthcare system. OBPI diagnoses and corresponding risk factors from 2004 to 2012 were identified and correlated with referrals to Canada’s 10 multidisciplinary OBPI centers. Quality indicators were approved by the Canadian OBPI Working Group’s guideline consensus group. The primary outcome was the timing of initial assessment at a multidisciplinary center, “good” if assessed by the time the patient was 1 month of age, “satisfactory” if by 3 months of age, and “poor” if thereafter. Joinpoint regression analysis was used to determine the OBPI incidence over the study period. Odds ratios were calculated to determine the strength of association for risk factors. RESULTS OBPI incidence was 1.24 per 1000 live births, and was consistent from 2004 to 2012. Potential biases underestimate the level of injury identification. The factors associated with a very strong risk for OBPI were humerus fracture, shoulder dystocia, and clavicle fracture. The majority (55%–60%) of OBPI patients identified at birth were not referred. Among those who were referred, the timing of assessment was “good” in 28%, “satisfactory” in 66%, and “poor” in 34%. CONCLUSIONS Shoulder dystocia was the strongest modifiable risk factor for OBPI. Most children with OBPI were not referred to multidisciplinary care. Of those who were referred, 72% were assessed later than the target quality indicator of 1 month that was established by the national guideline consensus group. A referral gap has been identified using quality indicators at clinically relevant time points; this gap should be addressed with the use of knowledge tools (e.g., a clinical practice guideline) to target variations in referral rates and clinical practice. Interventions should guide the referral process.

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Pattern and degree of forces applied during simulation of shoulder dystocia

Cited by 38 publications

References 13 publications

What is the impact of multi-professional emergency obstetric and neonatal care training?

What is the impact of multi-professional emergency obstetric and neonatal care training?

Prevention of brachial plexus injury—12 years of shoulder dystocia training: an interrupted time‐series study

Obstetrical brachial plexus injury: burden in a publicly funded, universal healthcare system

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