scholarly journals How often will midwives and obstetricians experience obstetric emergencies or high-risk deliveries: a national cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e050790
Author(s):  
Stinne Høgh ◽  
Line Thellesen ◽  
Thomas Bergholt ◽  
Ane Lilleøre Rom ◽  
Marianne Johansen ◽  
...  

ObjectiveTo estimate how often midwives, specialty trainees and doctors specialised in obstetrics and gynaecology are attending to specific obstetric emergencies or high-risk deliveries (obstetric events).DesignA national cross-sectional study.SettingAll hospital labour wards in Denmark.ParticipantsMidwives (n=1303), specialty trainees (n=179) and doctors specialised in obstetrics and gynaecology (n=343) working in hospital labour wards (n=21) in Denmark in 2018.MethodsCategories of obstetric events comprised of Apgar score <7/5 min, eclampsia, emergency caesarean sections, severe postpartum haemorrhage, shoulder dystocia, umbilical cord prolapse, vaginal breech deliveries, vaginal twin deliveries and vacuum extraction. Data on number of healthcare professionals were obtained through the Danish maternity wards, the Danish Health Authority and the Danish Society of Obstetricians and Gynaecologists. We calculated the time interval between attending each obstetric event by dividing the number of events occurred with the number of healthcare professionals.Outcome measuresThe time interval between attending a specific obstetric event.ResultsThe average time between experiencing obstetric events ranged from days to years. Emergency caesarean sections, which occur relatively frequent, were attended on average every other month by midwives, every 9 days for specialty trainees and every 17 days by specialist doctors. On average, rare events like eclampsia were experienced by midwives only every 42 years, every 6 years by specialty trainees and every 11 years by specialist doctors.ConclusionsSome obstetric events occur extremely rarely, hindering the ability to obtain and maintain the clinical skills to manage them through clinical practice alone. By assessing the frequency of a healthcare professionals attending an obstetric emergency, our study contributes to assessing the need for supplementary educational initiatives and interventions to learn and maintain clinical skills.

2020 ◽  
Author(s):  
Guillaume Sacco ◽  
Pauline Carliez ◽  
Frédéric Noublanche ◽  
Romain Simon ◽  
Anne Renaudin ◽  
...  

BACKGROUND Usability is the keystone in the evolution of tablet technology in healthcare. The Ardoiz® tablet has been designed with a simplified interface for older adults. OBJECTIVE To assess the perceived usability and satisfaction of the Ardoiz® tablet. METHODS We conducted a mixed methods with cross-sectional study using System Usability Scale (SUS), satisfaction score and workshops, including geriatric patients, healthcare professional and caregivers. RESULTS Between September 25, 2019 and March 11, 2020, 58 participants were included in a cross-sectional study (including 38 patients, mean ±SD 85±6 years, 66% women), 26 in workshops (including 5 patients, mean ±SD 86.4±2.9, 40% women). The SUS was 74±12/100, the satisfaction score was 2.8±0.9/4, with 59% of satisfied participants with the use of Ardoiz® pads. The intent to acquire remained low with 18% (n=6) of participants who would be interested in acquiring the tablet. This tablet computer seemed to be difficult to use by geriatric patients and healthcare professionals, mainly because of its complex homepage. Nevertheless, former caregivers and healthcare professionals thought that the tablet could be of great interest to hospitals for leisure and medical use. The main feedback in order to improve the tablet is to simplify the home page with fewer and more static icons (without switching). CONCLUSIONS Notwithstanding the usability of the tablet, the intent to acquire of Ardoiz® tablet remained low. The interface should be simplified for older adults in order to improve usability and adherence. CLINICALTRIAL NCT04091152


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saran Tenzin Tamang ◽  
Thinley Dorji ◽  
Sonam Yoezer ◽  
Thinley Phuntsho ◽  
Phurb Dorji

Abstract Background The third Sustainable Development Goal for 2030 development agenda aims to reduce maternal and newborn deaths. Pregnant women’s understanding of danger signs is an important factor in seeking timely care during emergencies. We assessed knowledge of obstetric danger signs using both recall and understanding of appropriate action required during obstetric emergencies. Methods This was a cross-sectional study among pregnant women attending antenatal clinic at Bhutan’s largest hospital in Thimphu. Recall was assessed against seven obstetric danger signs outlined in the Mother and Child Health Handbook (7 points). Understanding of danger signs was tested using 13 multiple choice questions (13 points). Knowledge was scored out of 20 points and reported as ‘good’ (≥80%), ‘satisfactory’ (60–79%) and ‘poor’ (< 60%). Correlation between participant characteristics and knowledge score as well as number of danger signs recalled was tested using Pearson’s correlation coefficient. Association between knowledge score and participant characteristics was tested using t-tests (and Kruskal-Wallis test) for numeric variables. Socio-demographic and clinical characteristics associated with the level of knowledge ('good’ versus ‘satisfactory’ and ‘poor’ combined) were assessed with odds ratios using a log-binomial regression model. All results with p < 0.05 were considered significant. Results Four hundred and twenty-two women responded to the survey (response rate = 96.0%). Mean (±SD) knowledge score was 12 (±2.5). Twenty women (4.7%) had ‘good’ knowledge, 245 (58.1%) had ‘satisfactory’ knowledge and 157 (37.2%) had ‘poor’ knowledge. The median number of danger signs recalled was 2 (IQR 1, 3) while 68 women (20.3%) could not recall any danger signs. Most women were knowledgeable about pre-labour rupture of membranes (96.0%) while very few women were knowledgeable about spotting during pregnancy (19.9%). Both knowledge score and number of danger signs recalled had significant correlation with the period of gestation. Women with previous surgery on the reproductive tract had higher odds of having ‘good’ level of knowledge. Conclusions Most pregnant women had ‘satisfactory’ knowledge score with poor explicit recall of danger signs. However, women recognized obstetric emergencies and identified the appropriate action warranted.


Author(s):  
Serena Barello ◽  
Rosario Caruso ◽  
Lorenzo Palamenghi ◽  
Tiziana Nania ◽  
Federica Dellafiore ◽  
...  

Abstract Purpose The purpose of the present cross-sectional study is to investigate the role of perceived COVID-19-related organizational demands and threats in predicting emotional exhaustion, and the role of organizational support in reducing the negative influence of perceived COVID-19 work-related stressors on burnout. Moreover, the present study aims to add to the understanding of the role of personal resources in the Job Demands-Resources model (JD-R) by examining whether personal resources—such as the professionals’ orientation towards patient engagement—may also strengthen the impact of job resources and mitigate the impact of job demands. Methods This cross-sectional study involved 532 healthcare professionals working during the COVID-19 pandemic in Italy. It adopted the Job-Demands-Resource Model to study the determinants of professional’s burnout. An integrative model describing how increasing job demands experienced by this specific population are related to burnout and in particular to emotional exhaustion symptoms was developed. Results The results of the logistic regression models provided strong support for the proposed model, as both Job Demands and Resources are significant predictors (OR = 2.359 and 0.563 respectively, with p < 0.001). Moreover, healthcare professionals’ orientation towards patient engagement appears as a significant moderator of this relationship, as it reduces Demands’ effect (OR = 1.188) and increases Resources’ effect (OR = 0.501). Conclusions These findings integrate previous findings on the JD-R Model and suggest the relevance of personal resources and of relational factors in affecting professionals’ experience of burnout.


Author(s):  
Raquel Adjafre da Costa Matos ◽  
Rita de Cassia Coelho de Almeida Akutsu ◽  
Renata Puppin Zandonadi ◽  
Raquel Braz Assunção Botelho

Dietitians as healthcare professionals could decrease their quality of life during the SARS-COV-2 pandemic period; therefore, this study aimed to compare Brazilian dietitians’ perceptions of quality of life before and during the pandemic. This nationwide cross-sectional research aimed to evaluate Brazilian dietitians’ quality of life before and in the course of the COVID-19 pandemic, using a previously validated self-administered instrument WHO-QOL-BREF in Brazilian-Portuguese. The questionnaire was composed of 26 items (four domains) to evaluate life quality (physical, psychological, social relationship, and environment). The questionnaire also presented some sociodemographic variables and three questions about the COVID-19 pandemic. It was applied using GoogleForms® platform (Google LLC, Mountain View, CA, USA). For the statistical analysis of data, Paired T-test, Chi-squared test, and Analysis of Variance were used. A total of 1290 Brazilian dietitians replied to the instrument. Comparing quality of life (QoL) before SARS-COV-2 (3.83 ± 0.59) and during the pandemic (3.36 ± 0.66), data was statistically different. Comparing prior and in the course of the COVID-19 pandemic, all variables and domains presented statistical differences (better before the pandemic period). Among Brazilian dietitians, the psychological health domain was the most affected. The Sars-Cov-2 pandemic negatively impacted the QoL of Brazilian dietitians since health professionals face changes in their lives because of work.


2021 ◽  
Vol 34 (2) ◽  
pp. 114-122
Author(s):  
Nilüfer Demirsoy ◽  
Hülya Öztürk ◽  
Nurdan Ergün Acar

Confidentiality is fundamental in building trust between patients and healthcare professionals. This research aims at presenting healthcare professionals’ opinions on patient privacy, using a 5-point Likert-type scale titled “Opinion of the Healthcare Professionals on Patient Privacy,” and 262 physicians’ and 231 nurses’ opinions were evaluated. Results showed that nurses and doctors working at emergency services got higher mean scores than those working at other units. Results revealed that doctors had the highest mean score for the item “ It is important that the patient’s body is not seen by other patients and professionals during the treatment,” while nurses had the highest mean score for the item “ I approach with due care to protect privacy in the work environment.” Results of this work highlight that patient’s right to privacy constitutes one of the most significant issues to be noted by healthcare professionals.


Author(s):  
Desirée Mena-Tudela ◽  
Susana Iglesias-Casás ◽  
Víctor Manuel González-Chordá ◽  
María Jesús Valero-Chillerón ◽  
Laura Andreu-Pejó ◽  
...  

Background: Obstetric violence is a worldwide public health problem, which seems greater in Spain. As no studies were found that identify the most representative healthcare professionals, times, and areas involved in obstetric violence, the objective of this work was to study at what time of maternity, with which professionals, and in what areas women identified obstetric violence. Methods: This descriptive, retrospective, and cross-sectional study was performed from January 2018 to June 2019. The main variables were the area (hospital, primary care, both), the time (pregnancy, birth, puerperium), and the professionals attending to women. Results: Our sample comprised 17,541 participants. The area identified with the most obstetric violence for the different studied variables was hospitals. Women identified more obstetric violence at time of birth. Findings such as lack of information and informed consent (74.2%), and criticism of infantile behavior and treatment (87.6%), stood out. The main identified healthcare professionals were midwives and gynecologists, and “other” professionals repeatedly appeared. Conclusions: Having identified the professionals, times, and areas of most obstetric violence in Spain, it seems necessary to reflect on not only the Spanish National Health System’s structure and management but also on healthcare professionals’ training.


BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e037464
Author(s):  
Haonan Jia ◽  
Huiying Fang ◽  
Ruohui Chen ◽  
Mingli Jiao ◽  
Lifeng Wei ◽  
...  

ObjectiveThe purpose of this study is to examine workplace violence (WPV) towards healthcare professionals in a multiethnic area in China, including prevalence, influencing factors, healthcare professionals’ response to WPV, expected antiviolence training measures and content, and evaluation of WPV interventions.DesignA cross-sectional study.SettingA grade III, class A hospital in the capital of Yunnan Province, which is the province with the most diverse ethnic minority groups in China.ParticipantsIn total, 2036 healthcare professionals participated, with a response rate of 83.79%.ResultsThe prevalence of physical and psychological violence was 5.5% and 43.7%, respectively. Healthcare professionals of ethnic minority were more likely to experience psychological violence (OR=1.54, 95% CI 1.16 to 2.05). Stratified by gender, male healthcare professionals of ethnic minority suffered from more physical violence (OR=3.31, 95% CI 1.12 to 9.79), while female healthcare professionals suffered from psychological violence (OR=1.71, 95% CI 1.24 to 2.36). We also found a unique work situation in China: overtime duty on-call work (18:00–07:00) was a risk factor for psychological violence (OR=1.40, 95% CI 1.02 to 1.93). Healthcare professionals of ethnic minority are less likely to order perpetrators to stop or to report to superiors when faced with psychological violence. They are also more interested in receiving training in force skills and self-defence. Both Han and ethnic minority participants considered security measures as the most useful intervention, while changing the time of shift the most useless one.ConclusionOur study comprehensively described WPV towards healthcare professionals in a multiethnic minority area. More research on WPV conducted in multiethnic areas is needed.


2016 ◽  
Vol 23 (12) ◽  
pp. 1527-1530
Author(s):  
Mobeen Ikram ◽  
Abdul Samee ◽  
Muhammad Amir ◽  
Muhammad Imdad

Objectives: To determine the frequency of failed spinal anesthesia in patientsundergoing caesarean section in a teaching hospital in Pakistan. Study Design: It was a cross– sectional study. Setting: Department of Anesthesia and Pain Management PAF HospitalSargodha. Period: January 2015 to May 2015. Methodology: A total of 293 pregnant patientsundergoing caesarean section under spinal anesthesia were included. After prehydration andessential monitoring, all patients were given spinal anesthesia with 25 G spinal needle at L3-L4 or L4-L5 level by 2nd year resident anesthesiologist under indirect supervision using 1.5 mlof hyperbaric spinal injection. Failure to achieve adequate block was managed by differentmodalities like sedation, analgesia with ketamine, repeat spinal anesthesia or to proceed withgeneral anesthesia. Results: Out of total of 293 patients, failed spinal occurred in 9 patients(3.07%). Out of these 9 patients, 02 patients (22.22%) were elective caesarean sections while07 cases (77.77%) were emergency caesarean sections. Conclusion: The chances of failedspinal anesthesia are more in emergency caesarean sections as compared to elective casesand failure rate of spinal anesthesia in PAF teaching hospital Sargodha is 3.07% which is slightlyhigher than 3%


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