Cargando…

The effects of obstetric emergency team training on patient outcome: A systematic review and meta‐analysis

INTRODUCTION: Little is known about the optimal simulation‐based team training in obstetric emergencies. We aimed to review how simulation‐based team training affects patient outcomes in obstetric emergencies. MATERIAL AND METHODS: Search Strategy: MEDLINE, Embase, Cochrane Library, and Cochrane Cen...

Descripción completa

Detalles Bibliográficos
Autores principales: Brogaard, Lise, Glerup Lauridsen, Kasper, Løfgren, Bo, Krogh, Kristian, Paltved, Charlotte, Boie, Sidsel, Hvidman, Lone
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9564821/
https://www.ncbi.nlm.nih.gov/pubmed/34622945
http://dx.doi.org/10.1111/aogs.14263
_version_ 1784808740651794432
author Brogaard, Lise
Glerup Lauridsen, Kasper
Løfgren, Bo
Krogh, Kristian
Paltved, Charlotte
Boie, Sidsel
Hvidman, Lone
author_facet Brogaard, Lise
Glerup Lauridsen, Kasper
Løfgren, Bo
Krogh, Kristian
Paltved, Charlotte
Boie, Sidsel
Hvidman, Lone
author_sort Brogaard, Lise
collection PubMed
description INTRODUCTION: Little is known about the optimal simulation‐based team training in obstetric emergencies. We aimed to review how simulation‐based team training affects patient outcomes in obstetric emergencies. MATERIAL AND METHODS: Search Strategy: MEDLINE, Embase, Cochrane Library, and Cochrane Central Register of Controlled Trials were searched up to and including May 15, 2021. Selection criteria: randomized controlled trials (RCTs) and cohort studies on obstetric teams in high‐resource settings comparing the effect of simulation‐based obstetric emergency team training with no training on the risk of Apgar scores less than 7 at 5 min, neonatal hypoxic ischemic encephalopathy, severe postpartum hemorrhage, blood transfusion of four or more units, and delay of emergency cesarean section by more than 30 min. Data collection and analysis: The included studies were assessed using PRISMA, EPCO, and GRADE. RESULTS: We found 21 studies, four RCTs and 17 cohort studies, evaluating patient outcomes after obstetric team training compared with no training. Annual obstetric emergency team training may reduce brachial plexus injury (six cohort studies: odds ratio [OR] 0.47, 95% CI 0.33–0.68; one RCT: OR 1.30, 95 CI% 0.39–4.33, low certainty evidence) and suggest a positive effect; but it was not significant on Apgar score below 7 at 5 min (three cohort studies: OR 0.77, 95% CI 0.51–1.19; two RCT: OR 0.87, 95% CI 0.72–1.05, moderate certainty evidence). The effect was unclear for hypoxic ischemic encephalopathy, umbilical prolapse, decision to birth interval in emergency cesarean section, and for severe postpartum hemorrhage. Studies with in situ multi‐professional simulation‐based training demonstrated the best effect. CONCLUSIONS: Emerging evidence suggests an effect of obstetric team training on obstetric outcomes, but conflicting results call for controlled trials targeted to identify the optimal methodology for effective team training.
format Online
Article
Text
id pubmed-9564821
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher John Wiley and Sons Inc.
record_format MEDLINE/PubMed
spelling pubmed-95648212022-12-06 The effects of obstetric emergency team training on patient outcome: A systematic review and meta‐analysis Brogaard, Lise Glerup Lauridsen, Kasper Løfgren, Bo Krogh, Kristian Paltved, Charlotte Boie, Sidsel Hvidman, Lone Acta Obstet Gynecol Scand Systematic Review INTRODUCTION: Little is known about the optimal simulation‐based team training in obstetric emergencies. We aimed to review how simulation‐based team training affects patient outcomes in obstetric emergencies. MATERIAL AND METHODS: Search Strategy: MEDLINE, Embase, Cochrane Library, and Cochrane Central Register of Controlled Trials were searched up to and including May 15, 2021. Selection criteria: randomized controlled trials (RCTs) and cohort studies on obstetric teams in high‐resource settings comparing the effect of simulation‐based obstetric emergency team training with no training on the risk of Apgar scores less than 7 at 5 min, neonatal hypoxic ischemic encephalopathy, severe postpartum hemorrhage, blood transfusion of four or more units, and delay of emergency cesarean section by more than 30 min. Data collection and analysis: The included studies were assessed using PRISMA, EPCO, and GRADE. RESULTS: We found 21 studies, four RCTs and 17 cohort studies, evaluating patient outcomes after obstetric team training compared with no training. Annual obstetric emergency team training may reduce brachial plexus injury (six cohort studies: odds ratio [OR] 0.47, 95% CI 0.33–0.68; one RCT: OR 1.30, 95 CI% 0.39–4.33, low certainty evidence) and suggest a positive effect; but it was not significant on Apgar score below 7 at 5 min (three cohort studies: OR 0.77, 95% CI 0.51–1.19; two RCT: OR 0.87, 95% CI 0.72–1.05, moderate certainty evidence). The effect was unclear for hypoxic ischemic encephalopathy, umbilical prolapse, decision to birth interval in emergency cesarean section, and for severe postpartum hemorrhage. Studies with in situ multi‐professional simulation‐based training demonstrated the best effect. CONCLUSIONS: Emerging evidence suggests an effect of obstetric team training on obstetric outcomes, but conflicting results call for controlled trials targeted to identify the optimal methodology for effective team training. John Wiley and Sons Inc. 2021-10-08 /pmc/articles/PMC9564821/ /pubmed/34622945 http://dx.doi.org/10.1111/aogs.14263 Text en © 2021 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG) https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Systematic Review
Brogaard, Lise
Glerup Lauridsen, Kasper
Løfgren, Bo
Krogh, Kristian
Paltved, Charlotte
Boie, Sidsel
Hvidman, Lone
The effects of obstetric emergency team training on patient outcome: A systematic review and meta‐analysis
title The effects of obstetric emergency team training on patient outcome: A systematic review and meta‐analysis
title_full The effects of obstetric emergency team training on patient outcome: A systematic review and meta‐analysis
title_fullStr The effects of obstetric emergency team training on patient outcome: A systematic review and meta‐analysis
title_full_unstemmed The effects of obstetric emergency team training on patient outcome: A systematic review and meta‐analysis
title_short The effects of obstetric emergency team training on patient outcome: A systematic review and meta‐analysis
title_sort effects of obstetric emergency team training on patient outcome: a systematic review and meta‐analysis
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9564821/
https://www.ncbi.nlm.nih.gov/pubmed/34622945
http://dx.doi.org/10.1111/aogs.14263
work_keys_str_mv AT brogaardlise theeffectsofobstetricemergencyteamtrainingonpatientoutcomeasystematicreviewandmetaanalysis
AT gleruplauridsenkasper theeffectsofobstetricemergencyteamtrainingonpatientoutcomeasystematicreviewandmetaanalysis
AT løfgrenbo theeffectsofobstetricemergencyteamtrainingonpatientoutcomeasystematicreviewandmetaanalysis
AT kroghkristian theeffectsofobstetricemergencyteamtrainingonpatientoutcomeasystematicreviewandmetaanalysis
AT paltvedcharlotte theeffectsofobstetricemergencyteamtrainingonpatientoutcomeasystematicreviewandmetaanalysis
AT boiesidsel theeffectsofobstetricemergencyteamtrainingonpatientoutcomeasystematicreviewandmetaanalysis
AT hvidmanlone theeffectsofobstetricemergencyteamtrainingonpatientoutcomeasystematicreviewandmetaanalysis
AT brogaardlise effectsofobstetricemergencyteamtrainingonpatientoutcomeasystematicreviewandmetaanalysis
AT gleruplauridsenkasper effectsofobstetricemergencyteamtrainingonpatientoutcomeasystematicreviewandmetaanalysis
AT løfgrenbo effectsofobstetricemergencyteamtrainingonpatientoutcomeasystematicreviewandmetaanalysis
AT kroghkristian effectsofobstetricemergencyteamtrainingonpatientoutcomeasystematicreviewandmetaanalysis
AT paltvedcharlotte effectsofobstetricemergencyteamtrainingonpatientoutcomeasystematicreviewandmetaanalysis
AT boiesidsel effectsofobstetricemergencyteamtrainingonpatientoutcomeasystematicreviewandmetaanalysis
AT hvidmanlone effectsofobstetricemergencyteamtrainingonpatientoutcomeasystematicreviewandmetaanalysis