title: Effect of education and clinical assessment on the accuracy of post partum blood loss estimation.
abstract: BACKGROUND
  This research aimed to assess the effect of health care provider education on the accuracy of post partum blood loss estimation.
  
  
  METHODS
  A non-randomized observational study that was conducted at King Abdulaziz Medical City, Riyadh, Saudi Arabia between January 1, 2011 and June 30, 2011. Hundred and twenty three health care providers who are involved in the estimation of post partum blood loss were eligible to participate. The participants were subjected to three research phases and an educational intervention. They have assessed a total of 30 different simulated blood loss stations, with 10 stations in each of the research phases. These phases took place before and after educational sessions on how to visually estimate blood loss and how to best utilize patient data in clinical scenarios. We have assessed the differences between the estimated blood loss and the actual measure. P-values were calculated to assess the differences between the three research phases estimations.
  
  
  RESULTS
  The participants significantly under-estimated post partum blood loss. The accuracy was improved after training (p-value < 0.0001) and after analysing each patient's clinical information (p-value = 0.042). The overall results were not affected by the participants' clinical backgrounds or their years of experience. Under-estimation was more prominent in cases where more than average-excessive blood losses were simulated while over-estimations or accurate estimations were more prominent in less than average blood loss incidents.
  
  
  CONCLUSIONS
  Simple education programmes can improve traditional findings related to under-estimation of blood loss. More sophisticated clinical education programmes may provide additional improvements.
authors.affiliation: Department of Obstetrics and Gynaecology, King Abdulaziz Medical City, King Saud bin Abdulaziz University for Health Sciences, PO Box 57374, Riyadh 11574, Saudi Arabia. halkadri@gmail.com.
authors.forename: Hanan M
authors.initials: HM
authors.lastname: Al-Kadri
authors.forename: Hanan
authors.initials: H
authors.lastname: Dahlawi
authors.forename: Mona
authors.initials: M
authors.lastname: Al Airan
authors.forename: Elham
authors.initials: E
authors.lastname: Elsherif
authors.forename: Nasser
authors.initials: N
authors.lastname: Tawfeeq
authors.forename: Yane
authors.initials: Y
authors.lastname: Mokhele
authors.forename: Drika
authors.initials: D
authors.lastname: Brown
authors.forename: Hani M
authors.initials: HM
authors.lastname: Tamim
mesh_terms: D000328:Adult; D003695:Delivery of Health Care / Q000592:standards*; D004501:Education, Medical / Q000592:standards*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000193:education*; D006801:Humans; D008297:Male; D008428:Maternal Mortality / Q000639:trends; D006473:Postpartum Hemorrhage / Q000175:diagnosis* / Q000453:epidemiology; D011247:Pregnancy; D015995:Prevalence; D012189:Retrospective Studies; D012529:Saudi Arabia / Q000453:epidemiology