Impact of a low-technology simulation-based obstetric and newborn care training scheme on non-emergency delivery practices in Guatemala. Issue 3 (March 2016)

• Record Type: Journal Article
• Authors: Walton, Anna; Kestler, Edgar; Dettinger, Julia C.; Zelek, Sarah; Holme, Francesca; Walker, Dilys
• Is Part Of: International journal of gynaecology and obstetrics. Volume 132:Issue 3(2016:Mar.)
• Page Start: 359
• Page End: 364
• Publication Date: 2016-03
• Subjects: Emergency obstetric and newborn care -- Guatemala -- Maternal mortality -- Neonatal mortality -- Skilled birth attendants -- Training; Gynecology -- Periodicals; Obstetrics -- Periodicals; Electronic journals; 618
• DOI: 10.1016/j.ijgo.2015.08.009
• Languages: English
• ISSNs: 0020-7292

Abstract

Abstract: Objective: To assess the effect of a low-technology simulation-based training scheme for obstetric and perinatal emergency management (PRONTO; Programa de Rescate Obstétrico y Neonatal: Tratamiento Óptimo y Oportuno) on non-emergency delivery practices at primary level clinics in Guatemala. Methods: A paired cross-sectional birth observation study was conducted with a convenience sample of 18 clinics (nine pairs of intervention and control clinics) from June 28 to August 7, 2013. Outcomes included implementation of practices known to decrease maternal and/or neonatal mortality and improve patient care. Results: Overall, 25 and 17 births occurred in intervention and control clinics, respectively. Active management of the third stage of labor was appropriately performed by 20 (83%) of 24 intervention teams versus 7 (50%) of 14 control teams ( P = 0.015). Intervention teams implemented more practices to decrease neonatal mortality than did control teams ( P < 0.001). Intervention teams ensured patient privacy in 23 (92%) of 25 births versus 11 (65%) of 17 births for control teams ( P = 0.014). All 15 applicable intervention teams kept patients informed versus 6 (55%) of 11 control teams ( P = 0.001). Differences were also noted in teamwork; in particular, skill-based tools were used more often at intervention sites than control sites ( P = 0.012). Conclusion: Use of PRONTO enhanced non-emergency delivery care by increasing evidence-based practice, patient-centered care, and teamwork.