Obstetric Emergency In Situ Simulation: Practice Leads to Change
Article first published online: 14 JUN 2012
© 2012 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses
Journal of Obstetric, Gynecologic, & Neonatal Nursing
Special Issue: 2012 Convention Proceedings
Volume 41, Issue s1, page S81, June 2012
How to Cite
Newhouse, L., Yeager, R. and Englehart, M. (2012), Obstetric Emergency In Situ Simulation: Practice Leads to Change. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 41: S81. doi: 10.1111/j.1552-6909.2012.01361_38.x
- Issue published online: 14 JUN 2012
- Article first published online: 14 JUN 2012
- emergency drills;
- in situ simulation;
- standardized patient;
- practice change
Purpose for the Program
The Joint Commission and the American College of Obstetricians and Gynecologists recommend using emergency drills/simulation to improve teamwork and communication.
High-fidelity simulation can be expensive. Because most obstetric emergencies involve moving the patient, our multidisciplinary team determined the best method of implementing emergency drills was to use in situ simulation using a standardized patient.
Implementation, Outcomes, and Evaluation
Participation in the monthly drills is mandatory for all labor and delivery staff and obstetric residents. Attendance is optional for private physicians. Before the drill begins everyone is given a role card and there is a short presentation on safety, teamwork, and communication. The drill is videotaped followed by a debriefing session. As a result of doing in situ drills, many opportunities to implement change were discovered. The primary nurse wears a red hat, which identifies her as the person to give the Situation-Background-Assessment-Recommendation. The role of the charge nurse and physician in emergency situations were delineated. Nurses have heightened awareness of how they can assist anesthesiologists. Nurses learned the importance of being able to work the operating room table. Oxygen masks are removed from the patient while she is being transported to the operating room. A nurse is designated to be a support person to the patient. Problems with our wireless communication system were identified and fixed and equipment was purchased. With more effective communication the noise level has decreased. Communication between disciplines has improved and physicians and nurses state they work more effectively as a team.
Implications for Nursing Practice
In situ simulation using a standardized patient can create learning opportunities that result in more effective communication, improved teamwork, and the ability to identify issues related to the physical environment.