Background: In 1997, the Institute of Medicine reported that between 48,000 to 98,000 people die in the US hospital due to preventable medical errors. Additionally, The Joint Commission reported that 65% of medical errors are due to failure in communication. Medical errors have impacted society because patients were harmed, with greater impact on the patient's families. Similarly, medical errors have impacted health care providers due to litigations, loss of status, loss of income, and potential loss of licensure. Simulations emerged as responses to rectify individual, organizational, and systems failures that resulted in patient harm. From ethical standpoint, the use of simulations conveys critical educational message: patients are to be protected whenever possible. They are not commodities to be used as conveniences of training. Simulations focus on improved communications, improved clinician's knowledge and skills in a controlled, risk-free environment. Simulation is an effective tool in promoting a culture that encourages identification of risks to medical errors in a non-punitive, risk-free environment. Foreground: High risk obstetric patients present challenges to the healthcare providers. Obstetric-related claims often represent high severity in terms of both injury and payouts. The average insurance payout ranges from $1.2 to $10 million. Researchers have shown that onsite simulations demonstrated a positive impact on obstetrical patient safety. These obestetric drills resulted in improved quality of care. EBP Framework: Knowledge dissemination was promoted through the use of a communication model, Organizational Information Theory developed by Karl Weick. Johns Hopkins Nursing Evidence-Based Model was used because of its similarity to nursing process in the utilization of a systematic approach. In addition, the model encourages the use of critical thinking in the acquisition of evidence-based knowledge. Methods: The purpose of this capstone project was to demonstrate that simulations in a labor and delivery unit in a community hospital can improve perinatal patient safety in a cost-effective manner through improved teamwork, improved communication and improved skills and knowledge. Simulations in the management of obstetric emergencies were performed through the use of roleplaying. The Safety Attitude Questionnaire (SAQ) tool was used to measure the team's perception of safety climate of the unit. Findings: The overall results of the SAQ survey demonstrated an improvement in the participants' perceptions of teamwork, safety, communication, job satisfaction, workplace condition, and perception of management. While the project was limited due to the low number of staff and physicians who participated in the project and no participation from the respiratory therapists, the overall results of the SAQ survey demonstrated some improvement in many areas. Conclusion: There are areas of concern; identification of these issues is critical in taking necessary steps to identify measures to improve them. Additionally, the SAQ results demonstrate a need for continued application of simulation and measurement of tthe obsetric multidisciplinary team's perception of communication, teamwork, safety, job satisfaction, and workplace condition.

The aim of this Executive Leadership Doctorate in Nursing Practice project was to assess the effectiveness of simulation-based training as a strategy to ensure patient safety and quality care by improving the knowledge and confidence of obstetric nursing staff. Collateral goals included the development of a simulation-based interactive training program to improve staff response to obstetric emergencies and the establishment of an Interprofessional Simulation Training Center. The use of simulation-based training is widely accepted ans used in healthcare education. Several benefits of simulation-based training include a learner-centered approach, safe acquisition of technical skills training and development of effective communication skills. Simulation-based training provides healthcare professionals the opportunity to be involved in simulated patient care scenarios without causing harm to actual patients. The labor and delivery unit is one of the vital areas in the hospital where the management of obstetric emergencies of laboring women, neonates, and postpartum mothers is critical and requires expert skills sets. the increasing number of harm events occurring in obstetrics warranted action. With this need identified, the decision was made to implement a simulation-based training program to improve participants' knowledge and confidence in their ability to intervene and manage obstetric emergencies. Project feedback from all participants i the simulation-based training program revealed a favorable climate for division-wide implementation.

Simulation is becoming an integral part of medical education and has already a well-established role within anaesthesia training, with many examination questions already modelled on simulation scenarios. The clinical diversity and multidisciplinary nature of an obstetric team creates the ideal environment for simulation training. It enables the team to develop their knowledge of clinical emergencies whilst becoming more aware of the importance of human factors. This book is a practical guide to inspire clinical leads to establish simulation within their delivery suite. The book comprises an extensive obstetric scenario library, with each scenario broken down into learning outcomes, a list of staff and equipment needed, specific stages mapped to learning outcomes with appropriate results/investigations and a checklist of ideal actions to enable the post-scenario debrief. Written by consultant obstetric anaesthetists, this book will appeal to medical practitioners interested in facilitating obstetric simulation.

Developed to improve patient safety during labor and delivery, the OB F.A.S.T. (Obstetrical Feasible Approach to Safety Training) simulation program is a proven, award-winning resource is designed for all members of the interdisciplinary obstetrics team to use together. Written by Dr. Giancarlo Mari, who developed the program and currently trains providers around the U.S. and the world, this volume helps teams strengthen their common knowledge of obstetric emergencies. This knowledge is then applied to rehearse emergencies together and prepare team members to provide a safe labor and delivery experience for every mother and child. Features easy-to-follow images and diagrams to reinforce team knowledge of common obstetric emergencies, from cardiac arrest and anesthesia considerations to intrapartum fetal monitoring and amniotic fluid embolism. Offers suggestions for how to run a simulation drill, as well as key points for debriefing and documentation. Includes essential background information to facilitate quick reference and skills checklists to evaluate team performance. Designed for every member of the obstetric team – from those who are new to the field to practitioners with years of experience.

This book will serve as a pocket guide, offering rapid advice on appropriate emergency care for a wide range of obstetric situations, including acute fetal hypoxia, uterine rupture, shoulder dystocia, eclampsia, amniotic fluid embolism, pulmonary thromboembolism, retention of the aftercoming head, major postpartum hemorrhage, and uterine inversion. For each emergency, the definition, diagnosis, and recommended management strategy are reviewed from a pan-European perspective. Regular review and training in obstetric emergencies is the only effective way to develop and maintain clinical competence in these rare and life-threatening situations, thus improving their management and the resulting outcomes. Healthcare professionals will find this book offers a practical and reliable source of information for dealing with dangerous and acute complications of pregnancy and childbirth.

Global and national confidential inquiry reports show that 60 to 80% of maternal and neonatal morbidity and mortality are due to avoidable errors. This comprehensive and illustrated second edition offers a practical guide to the management of obstetric, medical, surgical, anaesthetic and newborn emergencies in addition to organisational and training issues. The book is divided conveniently into nine sections and updated throughout in line with modern research and practice. Several new chapters cover setting up skills and drills training in maternity services to reduce avoidable harm, managing obstetric emergencies during 'home births' and in low-risk midwifery units, and minimizing maternal and fetal morbidity in failed operative vaginal delivery. Each chapter includes a practical algorithm for quick reference, the scientific basis for proposed actions, a case-based practical exercise and useful learning tools such as 'Key Pearls' and 'Key Pitfalls'. An invaluable resource for obstetricians, neonatologists, midwives, medical students, anesthesiologists and the wider perinatal team.

In this book the use of hybrid simulation in delivery room emergencies is described and shown. The use of a patient actor combined with a task trainer within the same session substantially improve the training for practical management of intrapartum emergencies in real life, reducing the risk of failure of operative vaginal delivery and of related adverse events, including perinatal or maternal complications. Furthermore, simulation with high reality computerized mannequin and scenography of emergency situation can improve technical and manual skills of the participants. For this book and the related videos, a new generation of mannequins suitable for both clinical manoeuvres and ultrasound examination is used to simulate all clinical scenarios of emergency that can happen in the delivery room for both the mother and the child. This unique book is a useful tool for medical students, residents, practicing pediatricians, anesthetists, obstetricians and all health care professionals working in the delivery room in their ability to deal with critical and emergency situations with safety and good medical practice.