Does Simulation Training in Obstetric Code Blue Improve Code Team Comfort Levels?

Abstract

Purpose: Obstetric (OB) cardiac arrests (codes), though rare, pose unique considerations. Anxiety is heightened in responding code teams. Methods: Healthcare workers responding to OB codes at Baylor University Medical Center underwent simulation training with Gaumard Scientific's Birthing Simulator, NOELLE (mimicked cardiac arrest and cesarean delivery). Pre-training comfort level and knowledge was assessed via anonymous survey, followed by a mock code after which feedback was provided. A lecture and tools were given to facilitate actions during a code-badge cards (listed 5 steps to initiate a code) and checklist (OB modifications, considerations for delivery, etc). Participants then repeated a mock code and anonymous assessments. Results: 66 participants completed training. 30% had actual OB code experience (11 in 1, 7 in 2-3, and 1 in 5). 81% had prior simulation training (30% with OB scenarios). When asked about comfort level in participating in an OB code, 45% were not at all comfortable, 36% were slightly comfortable, 17% were moderately comfortable and 2% were very comfortable-none were extremely comfortable. When asked about comfort level with the unique operations of an OB code, 55% were not at all comfortable, 30% were slightly comfortable, 14% were moderately comfortable and 1% were very comfortable. Post training, 96% reported an improved comfort level participating in an OB code: 2% were not at all comfortable, 38% were slightly comfortable, 46% were moderately comfortable and 14% were very comfortable. 96% became more aware of issues they had not previously appreciated. 94% reported an increased comfort level in identifying unique OB code operations: 9% were not at all comfortable, 34% were slightly comfortable, 45% were moderately comfortable and 12% were very comfortable. 93% found badge cards and checklist valuable and useful tools. Training was found to be useful by 96% and 86% wanted continued simulation involving different OB scenarios. Conclusions: Survey assessment showed improved comfort in OB codes. The tools seemed to help facilitate a trend toward improvement in both comfort level and appreciation for the unique operations of OB codes. Simulaiton was found to be useful and many wanted continued drills. Clinical Implications: OB codes are rare yet more complex in nature. Simulation training can benefit code team members in their execution and ease anxiety. This can be accomplished by not only simulation training but implementation of tools to assist in code execution.