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DOI: 10.1055/s-0036-1586118
Validating Obstetric Emergency Checklists using Simulation: A Randomized Controlled Trial
Publication History
10 June 2016
13 June 2016
Publication Date:
25 July 2016 (online)
![](https://www.thieme-connect.de/media/ajp/201612/lookinside/thumbnails/10-1055-s-0036-1586118_160271-1.jpg)
Abstract
Background The World Health Organization's Surgical Safety Checklist has demonstrated significant reduction in surgical morbidity. The American Congress of Obstetricians and Gynecologists District II Safe Motherhood Initiative (SMI) safety bundles include eclampsia and postpartum hemorrhage (PPH) checklists.
Objective To determine whether use of the SMI checklists during simulated obstetric emergencies improved completion of critical actions and to elicit feedback to facilitate checklist revision.
Study Design During this randomized controlled trial, teams were assigned to use a checklist during one of two emergencies: eclampsia and PPH. Raters scored teams on critical step completion. Feedback was elicited through structured debriefing.
Results In total, 30 teams completed 60 scenarios. For eclampsia, trends toward higher completion were noted for blood pressure and airway management. For PPH, trends toward higher completion rates were noted for PPH stage assessment and fundal massage. Feedback resulted in substantial checklist revision. Participants were enthusiastic about using checklists in a clinical emergency.
Conclusion Despite trends toward higher rates of completion of critical tasks, teams using checklists did not approach 100% task completion. Teams were interested in the application of checklists and provided feedback necessary to substantially revise the checklists. Intensive implementation planning and training in use of the revised checklists will result in improved patient outcomes.
Condensation
Multidisciplinary teams completed more critical clinical steps and were enthusiastic about the use of crisis checklists during maternal hemorrhage and eclampsia simulations.
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