Doctor of Nursing Practice
Date of Defense
Susan Dean-Baar, PhD, RN, CENP, FAAN
Melissa Ehmke, DNP, RN, CLC
Elizabeth Dykeman, MSN, RN
Problem: This quality improvement project aimed to improve the knowledge and confidence of the mother/baby nursing staff during postpartum hemorrhages through in situ simulation. PPH is a leading cause of maternal death. Hospitals across the U.S. lack a standard approach to managing obstetric emergencies; the complications of childbirth are often identified too late. Multidisciplinary simulation-based team training has been associated with improved outcomes in obstetrics.
Methods: A convenience sample of 26 registered nurses (RNs) that care for postpartum patients attended a one-hour instructor-led presentation followed by in situ simulations of postpartum hemorrhage. A knowledge assessment and confidence survey were administered pre-intervention and post-intervention. The pre-intervention and post-intervention scores were compared to determine knowledge and confidence gained following didactic and simulation exercises. A team of three observers rated each simulation exercise using the TeamSTEPPS Modified Team Performance Observation Tool (TPOT).
Results: The overall mean scores for the post-intervention confidence survey and knowledge assessment were statistically significantly higher than the mean scores for the pre-intervention confidence survey and knowledge assessment thus indicating overall improvement in participants’ knowledge gained and retained regarding a postpartum hemorrhage and improved confidence with their approach to managing a postpartum hemorrhage following didactic education and simulation exercises. Five of the seven simulation exercises had mean observer TPOT ratings greater than 4.0 (on a 5-point scale).
Implications for Practice: The ultimate goal is to expand the multidisciplinary team’s competence and confidence with all obstetric emergencies through simulation to improve maternal outcomes.
Wallen, Tram, "Increasing Nursing Competence and Confidence During Obstetric Emergencies Through Simulation: A Quality Improvement Project" (2019). Dissertations. 866.
Available for download on Thursday, July 23, 2020