Multi-professional training for obstetric emergencies in a U.S. hospital over a 7-year interval: an observational study

J Perinatol. 2016 Jan;36(1):19-24. doi: 10.1038/jp.2015.136. Epub 2015 Oct 29.

Abstract

Objective: Birth is less safe than it can be. We adapted the UK-developed PROMPT (PRactical Obstetric Multi-Professional Training) course to local practices and initiated annual training.

Study design: This observational study used quality assurance data from University of Kansas Hospital 2 years before and 7 years after intervention encompassing 14,309 consecutive deliveries from January 2006 through December 2014. An events/trials approach was applied to changes in proportions over time.

Result: PROMPT was associated with progressive decreases in rates (P<0.05) of brachial plexus injury and umbilical artery pH <7.00 exclusive of catastrophic events. Reduced rates (P<0.05) of cesarean section, episiotomy and higher perception of nurse/physician communication were documented. Hypoxic ischemic encephalopathy (HIE) rates declined progressively by >50% (P=NS). These improvements occurred despite younger faculty and higher rates of complicated pregnancies (P<0.05). Estimated health-care costs avoided exceeded annual training costs.

Conclusion: Local annual multi-professional training as provided by PROMPT was temporally associated with improved obstetric outcomes.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Delivery, Obstetric / standards*
  • Delivery, Obstetric / statistics & numerical data*
  • Emergencies / economics*
  • Female
  • Hospital Costs / statistics & numerical data*
  • Humans
  • Infant, Newborn
  • Missouri
  • Personnel, Hospital / education*
  • Physician-Nurse Relations
  • Pregnancy