scholarly journals Prehospital assessment and management of postpartum haemorrhage- healthcare personnel’s experiences and perspectives

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ann-Chatrin Linqvist Leonardsen ◽  
Ann Karin Helgesen ◽  
Linn Ulvøy ◽  
Vigdis Abrahamsen Grøndahl
Keyword(s):  
Collective Efficacy ◽  
Self Efficacy ◽  
Postpartum Haemorrhage ◽  
Healthcare Personnel ◽  
Free Text ◽  
Early Management ◽  
Common Causes ◽  
Coagulation Defects ◽  
And Training ◽  
Eastern Norway

Abstract Background Postpartum hemorrhage (PPH) is a serious obstetric emergency, and one of the top five causes of maternal mortality globally. The most common causes of PPH include uterine atony, placental disorders, birth trauma and coagulation defects. Timely diagnosis and early management are critical to reduce morbidity, the need for blood transfusion or even mortality. External, manual aortic compression (AC) has been suggested as an intervention that reduce PPH and extend time for control of bleeding or resuscitation. This procedure is not commonly utilized by healthcare personnel. The incidence of home-births is increasing, and competence in PPH assessment and management is essential in prehospital personnel. The objective was to explore prehospital personnel’s competence in PPH and AC, utilizing different tools. Methods The study was conducted in a county in South-eastern Norway, including five ambulance stations. All prehospital personnel (n = 250) were invited to participate in a questionnaire study. The questionnaire included the PPH self-efficacy (PPHSE) and PPH collective efficacy (PPHCE) tools, as well as tool developed utilizing the Delphi technique. Descriptive statistics were used to analyze the quantitative data, while quantitative content analysis was used to analyse free-text responses. Results A total of 87 prehospital personnel responded to the questionnaire, 57.5% male, mean age 37.9 years. In total, 80.4% were ambulance workers and/or paramedics, and 96.6 and 97.7% respectively reported to need more education or training in PPH. Moreover, 82.8% reported having managed patient(s) with PPH, but only 2.9% had performed AC. Prehospital personnels’ responses varied extensively regarding knowledge about what PPH is, how to estimate and handle PPH, and how to perform AC. Mean self-efficacy varied from 3.3 to 5.6, while collective efficacy varied from 1.9 to 3.8. Conclusions This study indicates that prehospital personnel lack knowledge about PPH and AC, due to various responses to the developed questionnaire. Even though AC is an acknowledged intervention in PPH, few participants reported that this was utilized. Our findings emphasize the need for education and training in PPH and PPH handling generally, and in AC specifically.

scholarly journals Prehospital Handling of Postpartum Haemorrhage- Healthcare Personnel’s Experiences and Perspectives

2020 ◽  
Author(s):  
Ann-Chatrin Linqvist Leonardsen ◽  
Ann Karin Helgesen ◽  
Linn Eik Ulvøy ◽  
Vigdis Abrahamsen Grøndahl
Keyword(s):  
Collective Efficacy ◽  
Self Efficacy ◽  
Educational Background ◽  
Healthcare Personnel ◽  
Free Text ◽  
Early Management ◽  
Common Causes ◽  
Coagulation Defects ◽  
And Training ◽  
Eastern Norway

Abstract Background: Postpartum hemorrhage (PPH) is a serious obstetric emergency, and one of the top five causes of maternal mortality globally. The most common causes of PPH include uterine atony, placental disorders, birth trauma and coagulation defects. Timely diagnosis and early management are critical to reduce morbidity, the need for blood transfusion or even mortality. External, manual aortic compression (AC) has been suggested as an intervention that reduce PPH and extend time for control of bleeding or resuscitation. This procedure is not commonly utilized by healthcare personnel. The incidence of home-births is increasing, and competence in PPH handling is essential in prehospital personnel. The objective was to explore prehospital personnel’s competence in PPH and AC, utilizing different tools. Methods: The study was conducted in a county in South-eastern Norway, including five ambulance stations. All prehospital personnel (n=250) were invited to participate in a questionnaire study. The questionnaire included the PPH self-efficacy (PPHSE) and PPH collective efficacy (PPHCE) tools, as well as a developed tool. Descriptive statistics were used to analyse the quantitative data, while quantitative content analysis was used to analyse free-text responses. Results: A total of 87 prehospital personnel responded to the questionnaire, 57.5 percent male, mean age 37.9 years. 80.4 percent were ambulance workers and/or paramedics, and 96.6 and 97.7 percent respectively reported to need more education or training in PPH. Results show that prehospital personnel lack knowledge about what PPH is, how to estimate and handle PPH, and how to perform AC. 82.8 percent reported having experienced PPH, but only 2.9 percent had performed AC. Mean self-efficacy varied from 3.3 to 5.6, while collective efficacy varied from 1.9 to 3.8. Educational background did not seem to have any impact on participants’ responses. Conclusions and implications: This study indicates that prehospital personnel lack knowledge about PPH and AC, and also report to need more education and training. Hence, PPH should be included in educational programs at all levels of the education, as well as in quality improvement initiatives. After the conduction of this study, prehospital personnel attended a digital course in PPH, as well as a practical course in AC.

scholarly journals Changes in self-efficacy, collective efficacy and patient outcome following interprofessional simulation training on postpartum haemorrhage

2017 ◽  
Vol 26 (19-20) ◽  
pp. 3174-3187 ◽  
Author(s):  
Signe Egenberg ◽  
Pål Øian ◽  
Torbjørn Moe Eggebø ◽  
Mirjana Grujic Arsenovic ◽  
Lars Edvin Bru
Keyword(s):  
Patient Outcome ◽  
Collective Efficacy ◽  
Self Efficacy ◽  
Simulation Training ◽  
Postpartum Haemorrhage

scholarly journals Clinical and Educational Outcomes of an Integrated Inpatient Quality Improvement Curriculum for Internal Medicine Residents

2016 ◽  
Vol 8 (4) ◽  
pp. 563-568 ◽  
Author(s):  
Greg Ogrinc ◽  
Emily S. Cohen ◽  
Robertus van Aalst ◽  
Beth Harwood ◽  
Ellyn Ercolano ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Quality Improvement ◽  
Self Efficacy ◽  
Intervention Group ◽  
Educational Outcome ◽  
Free Text ◽  
Internal Medicine Residents ◽  
Late Intervention ◽  
Hands On ◽  
The Impact

ABSTRACT Background  Integrating teaching and hands-on experience in quality improvement (QI) may increase the learning and the impact of resident QI work. Objective  We sought to determine the clinical and educational impact of an integrated QI curriculum. Methods  This clustered, randomized trial with early and late intervention groups used mixed methods evaluation. For almost 2 years, internal medicine residents from Dartmouth-Hitchcock Medical Center on the inpatient teams at the White River Junction VA participated in the QI curriculum. QI project effectiveness was assessed using statistical process control. Learning outcomes were assessed with the Quality Improvement Knowledge Application Tool–Revised (QIKAT-R) and through self-efficacy, interprofessional care attitudes, and satisfaction of learners. Free text responses by residents and a focus group of nurses who worked with the residents provided information about the acceptability of the intervention. Results  The QI projects improved many clinical processes and outcomes, but not all led to improvements. Educational outcome response rates were 65% (68 of 105) at baseline, 50% (18 of 36) for the early intervention group at midpoint, 67% (24 of 36) for the control group at midpoint, and 53% (42 of 80) for the late intervention group. Composite QIKAT-R scores (range, 0–27) increased from 13.3 at baseline to 15.3 at end point (P < .01), as did the self-efficacy composite score (P < .05). Satisfaction with the curriculum was rated highly by all participants. Conclusions  Learning and participating in hands-on QI can be integrated into the usual inpatient work of resident physicians.

scholarly journals Personal and Collective Efficacy Beliefs Scales to Educators: Evidences of Validity

Psico-USF ◽  
2015 ◽  
Vol 20 (3) ◽  
pp. 399-409 ◽  
Author(s):  
Daniela Couto Guerreiro Casanova ◽  
Roberta Gurgel Azzi
Keyword(s):  
Collective Efficacy ◽  
Self Efficacy ◽  
Convergent Validity ◽  
Good Evidence ◽  
Short Version ◽  
The Public ◽  
Two Factors ◽  
Teacher Self Efficacy ◽  
Similar Factor ◽  
Efficacy Criteria

Abstract This paper presents the Teacher Self-efficacy Scale, short version, and the School Collective Beliefs Scale adaptation and search of validities evidences process. After the semantic-cultural adaptation process, this study was composed by 380 educators from the public educational system in the state of São Paulo. The teacher self-efficacy scale, composed by 12 items, was organized into three factors. The School Collective Efficacy scale, composed by 12 items, was structured into two factors. Such adaptations, through the exploratory factor analysis yielded similar factor structure to the original scales, showed good evidence for variance explained, and internal consistency. Convergent validity was verified by the significant correlation between self-efficacy and collective efficacy. Criteria validity was verified through significant correlations between these beliefs and school performance. It is suggested to increase the sample size to confirm these results.

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