C P Weiner1, L Collins2, S Bentley2, Y Dong1, C L Satterwhite3. 1. Department of Obstetrics and Gynecology, University of Kansas School of Medicine, Kansas City, KS, USA. 2. Division of Nursing, University of Kansas Hospital, Kansas City, KS, USA. 3. Preventive Medicine, University of Kansas School of Medicine, Kansas City, KS, USA.
Abstract
OBJECTIVE: Birth is less safe than it can be. We adapted the UK-developed PROMPT (PRactical Obstetric Multi-Professional Training) course to local practices and initiated annual training. STUDY DESIGN: This observational study used quality assurance data from University of Kansas Hospital 2 years before and 7 years after intervention encompassing 14,309 consecutive deliveries from January 2006 through December 2014. An events/trials approach was applied to changes in proportions over time. RESULT: PROMPT was associated with progressive decreases in rates (P<0.05) of brachial plexus injury and umbilical artery pH <7.00 exclusive of catastrophic events. Reduced rates (P<0.05) of cesarean section, episiotomy and higher perception of nurse/physician communication were documented. Hypoxic ischemic encephalopathy (HIE) rates declined progressively by >50% (P=NS). These improvements occurred despite younger faculty and higher rates of complicated pregnancies (P<0.05). Estimated health-care costs avoided exceeded annual training costs. CONCLUSION: Local annual multi-professional training as provided by PROMPT was temporally associated with improved obstetric outcomes.
OBJECTIVE: Birth is less safe than it can be. We adapted the UK-developed PROMPT (PRactical Obstetric Multi-Professional Training) course to local practices and initiated annual training. STUDY DESIGN: This observational study used quality assurance data from University of Kansas Hospital 2 years before and 7 years after intervention encompassing 14,309 consecutive deliveries from January 2006 through December 2014. An events/trials approach was applied to changes in proportions over time. RESULT: PROMPT was associated with progressive decreases in rates (P<0.05) of brachial plexus injury and umbilical artery pH <7.00 exclusive of catastrophic events. Reduced rates (P<0.05) of cesarean section, episiotomy and higher perception of nurse/physician communication were documented. Hypoxic ischemicencephalopathy (HIE) rates declined progressively by >50% (P=NS). These improvements occurred despite younger faculty and higher rates of complicated pregnancies (P<0.05). Estimated health-care costs avoided exceeded annual training costs. CONCLUSION: Local annual multi-professional training as provided by PROMPT was temporally associated with improved obstetric outcomes.
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