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  • Original Article
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Multi-professional training for obstetric emergencies in a US hospital over a 7-year interval: an observational study

Journal of Perinatology volume 36, pages 19–24 (2016)Cite this article

Subjects

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.

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Acknowledgements

We are grateful to all the obstetrical staff who have annually contributed their time to PROMPT and the University of Kansas Hospital leadership for their public and financial support of PROMPT. We wish to thank Dr Prabhu Parimi, Professor and Division Head of Neonatology at the University of Kansas, for reviewing each patient with a diagnosis of HIE. Finally, we thank the team at PROMPT Maternity, Bristol, UK, a registered UK charity for all of their assistance over the last decade. This project was a product of annual Quality Assessment activities conducted by the University of Kansas Hospital. Quality Assessment activities such as these are generally considered exempt from Human Subjects Committee approval.

Author contributions

CPW directs the PROMPT™ program at the University of Kansas Hospital. He conceived of the study and is the primary author of the manuscript. He was intentionally excluded from data collection and analyses. LC is the Nurse Manager of the University of Kansas Labor Suite. She participated in data collection, and has read, edited and approved the content of the final manuscript. SB is a nurse midwife who was responsible for the Quality Assessment of obstetrics at the University of Kansas Hospital. She participated in data collection, and read, edited and approved the content of the final manuscript. YD is the Division Director of Research at the University of Kansas. He offered suggestions on the approach taken, and read, edited and approved the content of the final manuscript. CLS is a faculty member in the Department of Preventative Medicine at the University of Kansas. She performed all the statistical analyses, provided interpretation of the results, and read, edited and approved the content of the final manuscript.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University of Kansas School of Medicine, Kansas City, KS, USA

    C P Weiner & Y Dong

  2. Division of Nursing, University of Kansas Hospital, Kansas City, KS, USA

    L Collins & S Bentley

  3. Preventive Medicine, University of Kansas School of Medicine, Kansas City, KS, USA

    C L Satterwhite

Authors
  1. C P Weiner
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  2. L Collins
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  3. S Bentley
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  4. Y Dong
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Corresponding author

Correspondence to C P Weiner.

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Competing interests

Dr Weiner has directed without compensation PROMPT™ North America, a licensee of PROMPT Maternity, providing postgraduate multi-professional training to hospitals in the United States for obstetrical emergencies since April 2013. He has received less than $5000 per year serving as an instructor for PROMPT™ Train the Trainer courses.

Additional information

This study was presented in part and the recipient of the Prize Paper, Best Clinical Presentation at the 2014 annual meeting of the Society for Maternal Fetal Medicine.

Supplementary Information accompanies the paper on the Journal of Perinatology website

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Weiner, C., Collins, L., Bentley, S. et al. Multi-professional training for obstetric emergencies in a US hospital over a 7-year interval: an observational study. J Perinatol 36, 19–24 (2016). https://doi.org/10.1038/jp.2015.136

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  • DOI: https://doi.org/10.1038/jp.2015.136

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