Authors (including presenting author) :
Chau MCM(1), Ng SM(1), Chu WL(1), Chui KM(1), Wong MC(1), Lai KW(1), Cheng KY(1), , Lam KL(1)
Affiliation :
(1) Department of Obstetrics & Gynaecology, Prince of Wales Hospital, Hong Kong
Introduction :
Devastating obstetrics emergencies are uncommon events, but it could occur at anytime and anyplace. Regular drills or simulations can strengthen the skills and enhance midwives’ competence to manage such chaotic situations and finally to ensure good practice and improve patient outcome.
However, to organize a simulation drill needs to involve multidisciplinary teams and nearly whole team of midwives to participate in one time. The fast track is to conduct a comprehensive interactive verbal drill which is to avoid interrupt the busy ward routine and to involve more midwives to participate in different time point.
Objectives :
1. To strengthen the response to cope with obstetric emergencies
2. To enhance team communication skills
3. To identify performance gaps for quality improvement
Methodology :
We adopted the structure and model of Alliance of Innovation of Maternal Health to design our own maternal safety care bundles for varies emergency situations. The bundle has the elements of 4 “R”:
Readiness: to provide trainings ready for the emergency
Recognition and prevention: use assessment tool to recognize women’s deteriorating condition and to inform doctor promptly
Response: to carry out emergency response and practice SBAR communication skill
Reporting: to review the performance and debrief the team for improvement
After the comprehensive and systematic bundle is designed, a clinical scenario and a systematic checklist are prepared for the verbal drill. The conductor gathered 3 to 4 midwives to form a group in each drill. Before starting the drill, the procedure would be explained and each participant would be assigned a specific role.
Then the conductor presented the scenario and asked questions step by step which was guided by the scenario. The types of questions were including situation management, emergency response and full chain of emergency communications. Finally is to demonstrate how to operate the equipment.
Result & Outcome :
The program was started since 2020 in all O&G wards. Total 8 care bundles were designed such as cord prolapse in Antenatal ward, massive postpartum haemorrhage in Delivery Suite, eclampsia in Postnatal ward and septicemia shock in Gynae ward. “Verbal Drills” were then conducted. Over 95% of midwives in each ward had participated in the drills. The compliance rate of all the verbal drills was around 96% to 100%. Strengths and weaknesses were identified.
As more new comers and new graduate midwives are recruited, more care bundles and drills are worth to develop as a tool to conduct the verbal drills to maintain good practice and improve patient outcome.
