Etude rétrospective de type avant/après de l’impact d’une formation sur la prise en charge de l’hémorragie du post-partum immédiat

• Published in: Gynécologie, obstétrique, fertilité & sénologie Vol. 47; no. 5; pp. 465 - 470
• Main Authors: Lebrun-Grandie, V., Mattuizzi, A., Martin, A., Chabanier, P., Merlot, B., Elleboode, B., Longaygues, E., Saillour, F., Sentilhes, L.
• Format: Journal Article
• Language: French
• Published: Elsevier 2019
• Subjects: Life Sciences; Santé publique et épidémiologie; Training; Évaluation des pratiques professionnelles; Recommendations for clinical practice; Simulation; Professional practice evaluation; Post-partum hemorrhage; Recommandations pour la pratique clinique; Hémorragie du post-partum immédiat; Formation; Simulation exercise
• ISSN: 2468-7197; 2468-7189
• DOI: 10.1016/j.gofs.2019.03.005

OBJECTIVE: The aim of the study was to assess the impact of the introduction of training workshops on the quality of prevention and management of Post-Partum Hemorrhage (PPH) in a type III university center. MATERIALS AND METHODS: A clinical audit was carried out in our type III university center before and after the introduction of training workshops on the prevention and management of PPH, in two periods between January 1(st) to December 31(st) 2011 and March 1(st) and August 1(st), 2015. Training workshops were according to the recommendations for clinical practice of the National College of Gynecologists-Obstetricians French published in 2014, and included a theoretical portion and a simulation of low fidelity manikin. Data on the management of patients presenting with PPH after vaginal birth of a singleton were retrospectively collected consecutively from medical records. Data were collected using a standardized analytical grid. Between the two data collections, some improvement actions were implemented. RESULTS: After implementation of training workshops, the proportion of patients with active management of the third stage of labor (prophylactic uterotonic after delivery) has significantly improved (72% before, vs 92% after, p = 0,001) ; time to PPH diagnosis has been significantly higher notified (40% before, vs 94% after, p < 0,001), as well as the quantification of bleeding at diagnosis (46% before, vs 72% after, p < 0,003) and total bleeding (68% before, vs 92%, p < 0,001). PPH-specific monitoring sheet was found to be used significantly more frequently (3 before, vs 30 after, p = 0,00015). Additionally, the Physician Anesthesiologist has been contacted significantly more often (34% before, vs 53% after, p = 0,002). CONCLUSION: Our study highlights a significant improvement in professional practices between 2011 and 2015 on PPH prevention and management in our type III university center.