The Wyoming Medical Center is running a three-day simulation training event involving teams of doctors, nurses, and surgeons. The event is facilitated by the Swedish Medical Center from Seattle, Wash., which supplied a high-fidelity patient simulator named Noelle. The event aims to completely dissect the medical center’s system of care for postpartum hemorrhaging.
Nationally, about 5% of women experience postpartum hemorrhaging while giving birth. In 2014, the Wyoming Medical Center treated 58 women for postpartum hemorrhaging out of 1200 births. 54 of these cases were treated using medication, abdominal massage, or minimal intervention. Four patients required more aggressive treatments similar to the ones rehearsed in the simulation event.
Bleeding after childbirth is normal. However, in postpartum hemorrhage, this normal bleeding becomes excessive. While most cases can be treated with medication, some women require more aggressive treatment. The simulation exercises conducted at the Wyoming Medical Center are directed to improving the medical teams’ response to these emergency situations.
Postpartum hemorrhage is one of the leading cause of maternal mortality in developed countries. Although treatable, if not managed quickly, severe bleeding leads to tragedy. Through simulation training, the Wyoming Medical Center hopes to prepare their medical staff better for this emergency situation to increase positive patient outcomes.
The training is also helping the medical staff work as a cohesive team to provide care for the patient. Eight to ten medical professionals work together to assess the patient and treat the bleeding. As one nurse assesses the patient, another contacts the patient’s doctor, and the doctor gives care orders. The Rapid Response team is then called to move the patient to the OR.
Noelle is wireless and tetherless and controlled through a wireless tablet. She can also simulate a variety of physical ailments, so medical professionals recognize the signs and symptoms of severe bleeding. Therefore, Swedish Medical techs control Noelle through this tablet and change her vital signs – including heart rate and blood pressure, bleeding, eye movement and more through the computer.
Moreover, they can also make her speak, have a seizure or a heart attack. Thus, the medical team can practice how to respond to varies emergencies that are caused by severe bleeding. By rehearsing their response to these situations over and over again, then medical professionals will hone and master lifesaving skills.
Once in the OR, the team practices D&C (dilation and curettage) and insertion of a Bakri Balloon. These are vital lifesaving procedures used to manage and stop bleeding. By mastering these procedures, they become second nature. Thus, the risk of errors is reduced, and patient safety is improved.
At the end of the simulation, the medical staff debriefs and goes over what went right and what needs to be improved. One of the most important parts of the simulation process is the ability to go over errors and identify weak points. Then, the team can address these weaknesses and correct them.
Swedish Medical will use the simulation exercises to make a list of recommendations for Wyoming Medical Center to consider implementing in its processes. Swedish Medical will also take data from postpartum hemorrhages for 12 months prior to simulation and data 12 months after to show improvements in care resulting from the simulation exercises.