Simulation and nurse-mentoring in a statewide nurse mentoring program in Bihar, India: diagnosis of postpartum hemorrhage and intrapartum asphyxia

Background: Mentoring programs that include simulation, bedside mentoring, and didactic components are becoming increasingly popular to improve quality. These programs are designed with little evidence to inform the ideal composition of mentoring activities that would yield the greatest impact on provider skills and patient outcomes. We examined the association of number of maternal and neonatal emergency simulations performed with the diagnosis of postpartum hemorrhage (PPH) and intrapartum asphyxia in real patients.
Method: Prospective cohort. Between- and within-facility comparisons over time.
Setting: 320 public facilities in the state of Bihar, India May 2015 – 2017.
Participants: Deliveries and livebirths.
Interventions: Mobile nurse-mentoring program with simulations, teamwork and communication activities, didactic teaching, demonstrations of clinical procedures and bedside mentoring including conducting deliveries. Nurse mentor pairs visited each facility for one week, covering ...

研究背景：包含模拟训练、床边带教与授课模块的导师辅导项目正愈发普及，旨在提升医疗服务质量。但此类项目的设计缺乏相关证据支持，难以明确可对医护人员技能水平与患者临床结局产生最大正向影响的最优辅导活动组合。本研究探讨了所开展的孕产妇与新生儿急救模拟训练次数，与真实临床病例中产后出血（PPH）、产时窒息的诊断情况之间的关联。
研究方法：前瞻性队列研究。采用跨机构与机构内随时间变化的对比分析方案。
研究场景：2015年5月至2017年，印度比哈尔邦的320家公立医疗机构。
研究对象：分娩病例与活产儿。
干预措施：移动护士导师辅导项目，内容涵盖模拟训练、团队协作与沟通活动、授课教学、临床操作演示，以及包括接生在内的床边带教。每对护士导师会前往每家机构开展为期一周的辅导，覆盖……