title: Multi-professional training for obstetric emergencies in a U.S. hospital over a 7-year interval: an observational study.
abstract: OBJECTIVE
  Birth is less safe than it can be. We adapted the UK-developed PROMPT (PRactical Obstetric Multi-Professional Training) course to local practices and initiated annual training.
  
  
  METHODS
  This observational study used quality assurance data from University of Kansas Hospital 2 years before and 7 years after intervention encompassing 14,309 consecutive deliveries from January 2006 through December 2014. An events/trials approach was applied to changes in proportions over time.
  
  
  RESULTS
  PROMPT was associated with progressive decreases in rates (P<0.05) of brachial plexus injury and umbilical artery pH <7.00 exclusive of catastrophic events. Reduced rates (P<0.05) of cesarean section, episiotomy and higher perception of nurse/physician communication were documented. Hypoxic ischemic encephalopathy (HIE) rates declined progressively by >50% (P=NS). These improvements occurred despite younger faculty and higher rates of complicated pregnancies (P<0.05). Estimated health-care costs avoided exceeded annual training costs.
  
  
  CONCLUSIONS
  Local annual multi-professional training as provided by PROMPT was temporally associated with improved obstetric outcomes.
authors.affiliation: Department of Obstetrics and Gynecology, University of Kansas School of Medicine, Kansas City, KS, USA.
authors.forename: C P
authors.initials: CP
authors.lastname: Weiner
authors.affiliation: Division of Nursing, University of Kansas Hospital, Kansas City, KS, USA.
authors.forename: L
authors.initials: L
authors.lastname: Collins
authors.affiliation: Division of Nursing, University of Kansas Hospital, Kansas City, KS, USA.
authors.forename: S
authors.initials: S
authors.lastname: Bentley
authors.affiliation: Department of Obstetrics and Gynecology, University of Kansas School of Medicine, Kansas City, KS, USA.
authors.forename: Y
authors.initials: Y
authors.lastname: Dong
authors.affiliation: Preventive Medicine, University of Kansas School of Medicine, Kansas City, KS, USA.
authors.forename: C L
authors.initials: CL
authors.lastname: Satterwhite
mesh_terms: D036861:Delivery, Obstetric / Q000592:standards* / Q000706:statistics & numerical data*; D004630:Emergencies / Q000191:economics*; D005260:Female; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D007231:Infant, Newborn; D008923:Missouri; D010564:Personnel, Hospital / Q000193:education*; D019555:Physician-Nurse Relations; D011247:Pregnancy