title: Effect of on-site training on the accuracy of blood loss estimation in a simulated obstetrics environment.
abstract: OBJECTIVE
  To determine the effect of on-site training on the accuracy of blood loss estimation in a simulated obstetrics environment.
  
  
  METHODS
  In a tertiary hospital in Nigeria, clinical scenarios were created in April 2013 using known blood volumes in an objective structured clinical examination fashion. Doctors and nurses who worked in the obstetrics unit observed and recorded the blood volume at different clinical stations (first study stage). Subsequently, the actual amount of blood was revealed, followed by on-site training on the volume capacities of the study instruments. Three weeks later, the second stage of the study was performed like the first stage but using different amounts of blood for all stations. The differences in the mean errors of blood loss estimation between the two stages were determined.
  
  
  RESULTS
  The analysis included 144 healthcare providers who completed both stages of the study. There were significant differences in the mean error of blood loss estimation before and after the training session for the following stations: delivery bed (P<0.001), sanitary pad 1 (P=0.001), sanitary pad 2 (P=0.001), delivery pad (P=0.001), floor (P<0.001), and laparotomy pad (P=0.001).
  
  
  CONCLUSIONS
  Periodic education by simulation using clinical scenarios could improve the accuracy of visual blood loss estimation.
authors.affiliation: Department of Obstetrics and Gynecology, Nnamdi Azikiwe University, Nnewi, Nigeria.
authors.forename: Ikechukwu I
authors.initials: II
authors.lastname: Mbachu
authors.affiliation: Department of Obstetrics and Gynecology, Nnamdi Azikiwe University, Nnewi, Nigeria.
authors.forename: Gerald O
authors.initials: GO
authors.lastname: Udigwe
authors.affiliation: Department of Obstetrics and Gynecology, Nnamdi Azikiwe University, Nnewi, Nigeria.
authors.forename: Chukwuemeka O
authors.initials: CO
authors.lastname: Ezeama
authors.affiliation: Department of Obstetrics and Gynecology, Nnamdi Azikiwe University, Nnewi, Nigeria.
authors.forename: George U
authors.initials: GU
authors.lastname: Eleje
authors.affiliation: Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Johns Hopkins Medicine, Baltimore, MD, USA.
authors.forename: Ahizechukwu C
authors.initials: AC
authors.lastname: Eke
mesh_terms: D001810:Blood Volume; D002983:Clinical Competence; D004493:Education; D004521:Educational Measurement; D005260:Female; D006282:Health Personnel / Q000193:education* / Q000592:standards; D006801:Humans; D009549:Nigeria; D009774:Obstetrics / Q000193:education* / Q000592:standards; D006473:Postpartum Hemorrhage / Q000175:diagnosis*; D011446:Prospective Studies; D015203:Reproducibility of Results; D000066908:Simulation Training
keywords: Accuracy; Blood loss; Simulation; Training; Visual estimation