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BJOG. 2014 Dec;121(13):1710-8. doi: 10.1111/1471-0528.12767. Epub 2014 Apr 21.

Impact of introducing practical obstetric multi-professional training (PROMPT) into maternity units in Victoria, Australia.

Author information

1
VicPROMPT Pilot Project, Women and Children's Program, Eastern Health, Melbourne, Vic., Australia.

Abstract

OBJECTIVE:

To assess the introduction of Practical Obstetric Multi-professional Training (PROMPT) into maternity units and evaluate effects on organisational culture and perinatal outcomes.

DESIGN:

A retrospective cohort study.

SETTING:

Maternity units in eight public hospitals in metropolitan and regional Victoria, Australia.

POPULATION:

Staff in eight maternity units and a total of 43,408 babies born between July 2008 and December 2011.

METHODS:

Representatives from eight Victorian hospitals underwent a single day of training (Train the Trainer), to conduct PROMPT. Organisational culture was compared before and after PROMPT. Clinical outcomes were evaluated before, during and after PROMPT.

MAIN OUTCOME MEASURES:

The number of courses run and the proportion of staff trained were determined. Organisational culture was measured using the Safety Attitude Questionnaire. Clinical measures included Apgar scores at 1 and 5 minutes (Apgar 1 and Apgar 5), cord lactate, blood loss and length of baby's stay in hospital.

RESULTS:

Seven of the eight hospitals conducted PROMPT. Overall about 50% of staff were trained in each year of the study. Significant increases were found in Safety Attitude Questionnaire scores representing domains of teamwork (Hedges' g 0.27, 95% confidence interval [95% CI] 0.13-0.41), safety (Hedges' g 0.28, 95% CI 0.15-0.42) and perception of management (Hedges' g 0.17, 95% CI 0.04-0.31). There were significant improvements in Apgar 1 (OR 0.84, 95% CI 0.77-0.91), cord lactates (odds ratio 0.92, 95% CI 0.85-0.99) and average length of baby's stay in hospital (Hedges' g 0.03, 95% CI 0.01-0.05) during or after training, but no change in Apgar 5 scores or proportion of cases with high blood loss.

CONCLUSION:

PROMPT can be introduced using the Train the Trainer model. Improvements in organisational culture and some clinical measures were observed following PROMPT.

KEYWORDS:

Maternity; PROMPT; multi-professional training; pregnancy

PMID:
24751206
DOI:
10.1111/1471-0528.12767
[Indexed for MEDLINE]
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