Analysis of the care management protocol for COVID pregnant women and detection of improvement proposals applying clinical simulation methodology

Rev Esp Anestesiol Reanim (Engl Ed). 2020 Nov;67(9):487-495. doi: 10.1016/j.redar.2020.07.010. Epub 2020 Oct 6.
[Article in English, Spanish]


Introduction: The current SARS-CoV-2 pandemic has been the world's largest socio-health crisis experienced in the last century. Each healthcare center has been compelled to adapt the treatment guidelines established by the different scientific societies.

Objectives: Analyze the impact of the methodology based on simulation as a tool to improve our clinical practice: work dynamics, effectiveness and safety of all the physicians involved in the management of labor in COVID pregnant women and its usefulness to facilitate the adaptation of protocols to a specific clinical context.

Method: Descriptive observational study that includes the C-sections and deliveries of COVID pregnant women performed in our hospital. The actions carried out in each procedure were analyzed using the simulation multidisciplinary briefing and debriefing tools, before and after each case.

Results: A total of 5 clinical cases were analyzed. Difficulties were found in the execution of the protocols established for the care of the COVID pregnant. Organizational, structural, material resources and human factors obstacles were the most common.

Conclusions: Our results showed that the analysis example using simulation methodology was a tool of great value in three aspects: teamwork improvement, actions consent and improvement proposals for the adaptation and implementation of protocols.

Keywords: Briefing; COVID pregnant; Debriefing; Factores humanos; Gestantes COVID; Human factors; Protocolo; Protocols; Simulación; Simulation; Teamwork; Trabajo en equipo.

Publication types

  • Case Reports
  • Observational Study

MeSH terms

  • Adult
  • Betacoronavirus*
  • COVID-19
  • COVID-19 Testing
  • Cesarean Section
  • Clinical Decision-Making
  • Clinical Laboratory Techniques / methods
  • Clinical Protocols
  • Coronavirus Infections / diagnosis
  • Coronavirus Infections / epidemiology
  • Coronavirus Infections / therapy*
  • Delegation, Professional
  • Delivery, Obstetric / methods*
  • Emergencies
  • Female
  • Humans
  • Interdisciplinary Communication
  • Pandemics
  • Patient Care Team / organization & administration*
  • Personnel Staffing and Scheduling
  • Pneumonia, Viral / diagnosis
  • Pneumonia, Viral / epidemiology
  • Pneumonia, Viral / therapy*
  • Pregnancy
  • Pregnancy Complications, Infectious / epidemiology
  • Pregnancy Complications, Infectious / therapy*
  • SARS-CoV-2
  • Simulation Training / methods*
  • Young Adult