The objective of this study was to examine nurses’ perceptions of participating in obstetrical hemorrhage simulation training. Obstetrical hemorrhage is a common cause of maternal death in the United States. In 2009, Illinois mandated training for obstetrical hemorrhage using multidisciplinary simulation drills as a safe learning environment for health care workers. There was limited information how nurses translated this training into practice.

Design:

Qualitative research using focus groups.

Setting:

The Women’s and Infant’s Health Service department of a Level III perinatal center in a large Midwest Medical Center.

Patients/Participants:

Participants included nurses working in labor and delivery or family centered care. Nurses volunteered to participate in one of three focus groups. The sample of convenience included a total of 18 female nurses aged 27 to 53 years, with a range of obstetrical experience from 10 months to 31 years. Six of the participants reported they had not experienced an obstetrical hemorrhage prior to the training.

Methods:

The study was approved by the health system IRB. The need to sign a consent form was waived to ensure confidentiality; participation was considered implied consent. Participants completed a brief demographic questionnaire and were asked predetermined questions related to their perceptions of the training and subsequent experience treating obstetrical hemorrhage. All focus groups were audiotaped and transcribed verbatim; sessions lasted approximately 1 hour and 45 minutes.

Results:

Five main themes reflected the participant’s perceptions of the training: training viewed as valuable, multidimensional approach to training was beneficial, impact on practice, challenges to implementation, and recommendations to sustain learning. Training was viewed as valuable as nurses reported increased preparedness, role clarity, multidisciplinary interactions, and increased confidence. They described benefits of the multidimensional approach which included lectures, simulation, skills stations and debriefing sessions; additionally participants reported different perceptions based on the clinical unit worked. Participants described the translation of training as changing their practice including a systematic and organized response, actual practice change, informal teaching, improved teamwork, and improved patient safety. Conversely, participants reported challenges such as inconsistent implementation of training elements, perception of delayed response time, and different policies by nursing unit. Lastly, participants recommended ways learning could be sustained including refreshers, debriefing sessions in practice and additional practice changes.

Conclusion/Implications for nursing practice:

The findings will be used to modify future training programs for nurses and make changes to clinical care to improve patient outcomes and safety.

Keywords: Obstetrical hemorrhage Focus groups Simulation