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GO MOMS Nicaragua Project Abstract


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GO MOMS Nicaragua Project Abstract

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GO MOMS Nicaragua Project Abstract

  1. 1. SIMULATION-BASED TRAINING OF OBSTETRIC PROVIDERS IN NICARAGUA Kay Daniels MD1 , Antonia Nicosia MD2 , Shauna Brodie RN,NP3 , Jolyn Chen MD2 , Maria Auxiliadora Baca MD4 , Maurice Druzin MD1 1 Dept of Obstetrics and Gynecology Stanford Health Care, 2 Kaiser Permanent Hospital 3 University of California San Francisco, Stanford University School of Medicine, 4 Hospital Esquela Oscar Danilo Rosales Arguello, Leon, NIcaragua BACKGROUND METHODS FINDINGS INTERPERTATION This project validates that SBT can be successfully introduced to low resource areas. Although SBT originated in the developed world, its use is perhaps more applicable in the developing world where literacy and educational levels vary. Importantly simulation does not require expensive resources beyond the human capital to facilitate the scenarios. As stated by one of the Nicaraguan faculty members “Sometimes we talk about what we do in emergencies… but it stops there. You can know the text, but in the moment when you’re doing it, for reasons of fear, or time pressure, you forget it. When you have had simulation experiences, you learn how to do it well the first time and now, you will do it that way forever.” We conducted 3 in country visits: Visit 1: Needs Assessment Visit 2: Training of HEODRA faculty to perform simulation based teaching for: a)Postpartum hemorrhage b)Active management of the third stage of labor c)Preeclampsia/eclampsia management d)Shoulder dystocia e)In situ labor and delivery simulation Visit 3: Observation of HEODRA faculty performing simulation courses by researchers A post event survey was sent out to all participating HEODRA faculty after 6 months “The vast majority of maternal deaths are avoidable. The presence of a trained health-care worker during delivery is crucial in reducing maternal deaths.” * Studies in the developed world have demonstrated improved patient outcome after simulation-based training (SBT). The goal of this project was to train educators in a low resource environment to implement and sustain a SBT program for obstetrical emergencies. Nicaragua is the second poorest country in the Western hemisphere with a maternal mortality of 95/100,000 births in comparison with the USA rate of 17/100,000 births. The institution chosen for this study was Hospital Escuela Oscar Danilo Rosales Arguello (HEODRA) a public teaching hospital that performs >5000 deliveries a year. The training program participants consisted of 28 residents and 21 faculty. At visit #3 HEODRA faculty were observed to successfully incorporate SBT in to their teaching curriculum 6 month post course survey results revealed improved self efficacy and a change in practice: 1)17 of 22 reported a change in their practice after participating in the program 2) 5 of 22 have now placed a B lynch compression suture 3)17/22 felt more confident about placing a B lynch compression suture 4)All faculty stated they felt comfortable using simulation for teaching * Millennium Development Goals 2011