Seminars in perinatology
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Seminars in perinatology · Jun 2013
ReviewSimulation in maternal-fetal medicine: making a case for the need.
Medical error remains a cause for concern in obstetrics. Studies have shown that the most important contributing factors to adverse events in obstetrics often relate to poor teamwork and ineffective communication. ⋯ Simulation is a valuable tool which can be utilized, in obstetrics and maternal-fetal medicine, as an integral part of programs designed to advance knowledge and technical skills; improve communication and team function; and identify and correct systems issues. Simulation should be an integral part of our journey towards high reliability with the ultimate goal of improving patient safety and quality of care in obstetrics.
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Seminars in perinatology · Jun 2013
ReviewObstetric simulation for medical student, resident, and fellow education.
Simulation for training new providers is no longer the wave of the future, but the reality of the present. It provides significant activation and allows for both the integration of concepts with actual application and the ability to practice a wide range of procedural skills at an earlier stage of training than would otherwise be possible. ⋯ Almost all of the skills needed, even for advanced invasive procedures, in obstetrics can be taught with currently available simulators. In this report we will discuss the use of medical simulation for training obstetric providers from medical school through subspecialty level training.
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Simulation for obstetric emergencies has progressed from being a good idea in theory to the level of an evidence-based intervention that can improve outcomes. Though not a stand-alone solution, the inclusion of simulation for training individuals and teams to react and perform correctly when obstetric emergencies occur is a critical part of a comprehensive strategy to improve outcomes for both the mother and baby. In this article, we will briefly review both the recent history of simulation for obstetric emergencies and then examine the most current evidence for specific emergencies.
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Seminars in perinatology · Jun 2013
ReviewMoving forward in patient safety: multidisciplinary team training.
Communication and teamwork deficiencies have been identified as major contributors to poor clinical outcomes in the labor and delivery unit. In response to these findings, multidisciplinary simulation-based team training techniques have developed to focus specifically on skills training for teams. ⋯ Multidisciplinary simulation-based team training is also being used to detect latent system errors in existing or new units, to rehearse complicated procedures (surgical dress rehearsal), and to identify knowledge gaps of labor and delivery teams. Multidisciplinary simulation-based team training should be an integral component of ongoing quality-improvement efforts to ultimately produce teams of experts that perform proficiently.
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Seminars in perinatology · Apr 2013
ReviewLong-term pulmonary outcomes of patients with bronchopulmonary dysplasia.
Bronchopulmonary dysplasia (BPD) is the commonest cause of chronic lung disease in infancy. The incidence of BPD has remained unchanged despite many advances in neonatal care. BPD starts in the neonatal period but its effects can persist long term. ⋯ Even in the absence of clinical symptoms, BPD survivors have persistent radiological abnormalities and presence of emphysema has been reported on chest computed tomography scans. Concern regarding their exercise tolerance remains. Long-term effects of BPD are still unknown, but given reports of a more rapid decline in lung function and their suspectibility to develop chronic obstructive pulmonary disease phenotype with aging, it is imperative that lung function of survivors of BPD be closely monitored.