simulation training in obstetric emergencies...obstetric emergencies dr. thomas kou associate...
TRANSCRIPT
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Simulation training in Obstetric emergencies
Dr. Thomas Kou Associate consultant, O&G, QEH
7th May 2012
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Meeting the challenges
Influx of mainland China expectant mothers -> overwhelm Obstetric, neonatology, ICU services, etc
HA decreased quota for non-entitled persons (NEP) since April 2011
Dramatic increase in non-booked labouring patients attending A&E at the last minute
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Meeting the challenges
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Meeting the challenges
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Meeting the challenges
Pose an unique and important challenge to A&E department
Less familiar with delivery process
High risk of complications: No regular antenatal checkup In advanced labour Antenatal complications are not
managed properly eg. Big baby, growth restriction, gestational diabetes, etc.
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How to meet the challenges?
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Design
The solution is to provide simulation training
A multidisciplinary team
Obstetricians
Midwives
Paediatricians
A&E staff
Multi-Disciplinary Simulation and Skills Centre (MDSSC)
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Design
Target:
Schedule
16th September 2011
9th December 2011
27th March 2012
Coming 3 more sessions
All A&E doctors and nurses
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Design
Why simulation training? Low cost
High fidelity
Better engagement of trainees
Promising study results on obstetric simulation training
Venue: Multi-Disciplinary Simulation and Skills Centre of QEH
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Design
Stations:
1. Managing a normal spontaneous delivery
2. Shoulder dystocia
3. Cord prolapse
4. Neonatal resuscitation
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Design
Trainee manuals: pre-reading
Lectures (15 minutes on each topic)
Hand-on practices
Debriefing
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Station 1: Normal spontaneous delivery
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Station 2: Shoulder dystocia
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Station 3: Cord prolapse
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Station 4: Neonatal resuscitation
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Evaluations
Total participants: 61
Doctors : 20 (33%) Nurses : 41 (67%) Return of evaluation forms : 59/61 (97%)
No. of doctors No. of Nurses Total
16th Sept 2011 8 13 21
9th Dec 2011 5 16 21
27th Mar 2012 7 12 19
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Evaluations
Questions Yes No
1. The program was useful and informative 59/59 (100%) 0/59
2. The aims and objectives were clear 59/59 (100%) 0/59
3. Learning objective were achieved 59/59 (100%) 0/59
4. The learning-teaching activities were congruent which the overall program objectives and content
59/59 (100%) 0/59
5. The presenter/speaker/facilitator have demonstrated up-to-date professional knowledge and expertise
59/59 (100%) 0/59
6. The teaching method was appropriate 59/59 (100%) 0/59
7. The facility (e.g. venue) was appropriate 59/59 (100%) 0/59
8. The length of the program was: Too long About right Too short
0/59 56/59 (95%) 3/59 ( 5%)
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Evaluations
Other comments:
Extend the workshop to full day session
Videos can be added
Add vaginal breech delivery/pre-eclampsia
Clinical attachment to labour room
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Conclusions
Feedbacks from trainees and trainers are encouraging and reflect high satisfaction
The workshop will be run regularly to meet the demand and enhance A&E staff’s competency in managing obstetric emergencies
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Future
? More NEP attending A&E in 2013 after quota becomes zero
Extend to A&E in other hospitals which are without obstetric support (8 HA hospitals)
More types of emergencies scenarios
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