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Proficiency-based progression training: implementing a novel approach to training for epidural analgesia in labour.
Mohamed, H; McAuliffe, N; O'Connor, R; Ceballos Salazar, A; Zohaib Aslam, M; Kallidaikurichi Srinivasan, K; Iohom, G; Shorten, G.
Afiliación
  • Mohamed H; Department of Anaesthesia and Intensive Care, Faculty of Medicine, Cairo University, Cairo, Egypt; Department of Anaesthesia and Intensive Care, Leeds Teaching Hospitals, Leeds, UK. Electronic address: hassan.ahmed7@nhs.net.
  • McAuliffe N; Department of Anaesthesia and Intensive Care, Cork University Hospital, Cork, Ireland.
  • O'Connor R; Department of Anaesthesia, University College Cork, Cork, Ireland.
  • Ceballos Salazar A; Department of Anaesthesia and Intensive Care, Royal Papworth Hospital, Cambridge, UK.
  • Zohaib Aslam M; Department of Anaesthesia and Intensive Care, Cork University Hospital, Cork, Ireland.
  • Kallidaikurichi Srinivasan K; Department of Anaesthesia and Intensive Care, Tallaght University Hospital, Dublin, Ireland.
  • Iohom G; Department of Anaesthesia and Intensive Care, Cork University Hospital, Cork, Ireland; Department of Anaesthesia, University College Cork, Cork, Ireland.
  • Shorten G; Department of Anaesthesia and Intensive Care, Cork University Hospital, Cork, Ireland; Department of Anaesthesia, University College Cork, Cork, Ireland; Insight II SFI Research Centre, Ireland.
Int J Obstet Anesth ; 48: 103213, 2021 Nov.
Article en En | MEDLINE | ID: mdl-34500191
BACKGROUND: Epidural insertion is a challenging anaesthetic procedural skill to learn and may require up to 75 attempts to achieve competency. Proficiency-based progression (PbP) training based on unambiguously defined metrics was associated with a 53% reduction in epidural failure rate. The aim of this observational study was to examine the feasibility of implementation of innovative PbP training for labour epidural insertion performed by novices in a busy tertiary hospital. METHODS: All trainees who were scheduled to commence their obstetric anaesthesia training were invited to participate. Novices undertook intensive PbP training with one-to-one supervision by an anaesthetist trained in PbP. Trainees proceeded to the clinical phase only after attaining the pre-defined proficiency benchmark. All subsequent attempts at labour epidural catheter placement were evaluated. RESULTS: All 12 novice trainees who were scheduled for their initial exposure to obstetric anaesthesia completed PbP training in epidural catheter insertion successfully. The average duration of the training courses was 70 (SD 11) min. Trainee characteristics were broadly similar. They performed a total of 180 labour epidural catheter placements with an overall epidural failure rate of 12.2% (22/180). The proportion of supervisor takeover was 6% (11/179). The incidence of complications was 4% (8/180) and difficulty in epidural catheter insertion due to patient factors was 16% (29/180). Patient satisfaction rates were 80% (satisfied or very satisfied), with 20% unsatisfied with their experience of epidural insertion. CONCLUSION: In our experience, PbP training in epidural placement is feasible within existing departmental resources in a busy tertiary teaching hospital setting.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trabajo de Parto / Analgesia Epidural / Analgesia Obstétrica / Internado y Residencia / Anestesia Epidural Tipo de estudio: Observational_studies Límite: Female / Humans / Pregnancy Idioma: En Revista: Int J Obstet Anesth Asunto de la revista: ANESTESIOLOGIA / OBSTETRICIA Año: 2021 Tipo del documento: Article Pais de publicación: Países Bajos
Texto completo
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trabajo de Parto / Analgesia Epidural / Analgesia Obstétrica / Internado y Residencia / Anestesia Epidural Tipo de estudio: Observational_studies Límite: Female / Humans / Pregnancy Idioma: En Revista: Int J Obstet Anesth Asunto de la revista: ANESTESIOLOGIA / OBSTETRICIA Año: 2021 Tipo del documento: Article Pais de publicación: Países Bajos