“Innovation, Collaboration and Systemness. Three Sisters Playing Nice in the Sandbox.”

Purpose for the program: Patient safety is in the forefront of education in the healthcare profession.  The promotion of open communication and teamwork using obstetrical simulation is the purpose of an innovative program introduced to our healthcare system.  A new simulation lab was constructed at the College of Nursing within the system.  The sister facilities are located within a 30 mile radius and attempt to attract the same patient population.   

Proposed change: An obstetrical simulation planning committee was formed to include educators from the three facilities within the healthcare system.  The planning committee corresponded via emails and monthly meetings to develop a comprehensive plan for incorporating simulation as an educational component for nurses working on obstetrical units and share patient safety goals.   

Implementation, outcomes and evaluation: Through scheduled monthly meetings the committee shared numerous ideas to support a fiscally responsible implementation plan.  The drills are designed to enhance the learning of the nurse by incorporating the use of psychomotor skills.  The nurse will also role play and care for a woman through the stages of labor and delivery using the simulator.  Responding appropriately to spontaneous obstetrical emergencies including shoulder dystocia and precipitous delivery are the first areas covered during the implementation of simulation.

Implications for nursing practice: Meaningful implications for the simulation training include effective communication as an interdisciplinary team, safe collaborative care to the obstetrical simulator in the ante-, intra-, and post-partum periods, and incorporate the collaboration of facilities to increase competency in varying skill mixes.  The labor and delivery staff nurses are required to participate in four hours of simulation training annually.  The scheduling of nurses from three facilities will allow sixteen nurses to participate in training per month.  Learning modules on shoulder dystocia and precipitous delivery were constructed to optimize the learning experience for each nurse.  The modules contain objectives for each simulation module, pertinent educational materials and learning assessments.  Confidence level scoring will be performed by the nurse to evaluate the effectiveness of the simulation. 

Keywords: patient safety, teamwork, simulation, obstetrical emergencies