The effect of live and web-based education on the accuracy of blood-loss estimation in simulated obstetric scenarios.

OBJECTIVE Visual estimation of blood loss has been shown to be inaccurate. The objective of this study was to evaluate the impact of a didactic training program on the accuracy of the estimation of blood loss and to compare the effectiveness of training provided by a web-based vs live session. STUDY DESIGN Multidisciplinary labor and delivery unit personnel participated in live or web-based training. Both sessions comprised a 5-station pretest and posttest. The primary outcome was the accuracy of estimated blood loss in the pretest compared with the posttest with the use of the Mann-Whitney U test. RESULTS Among 372 providers, the median improvement between pre- and posttest results was 34% (95% confidence interval, 10-57%; P < .001). This improvement did not differ significantly between the live sessions and web-based sessions (4%; 95% confidence interval, -10% to 12%). CONCLUSION Our study supports the use of live or web-based training to improve blood loss estimation accuracy.

[1]  R. Williamson,et al.  Method for Calculating Blood Loss at Vaginal Delivery , 1981, Southern medical journal.

[2]  P. Lumbiganon,et al.  Accuracy of the blood loss estimation in the third stage of labor , 2000, International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics.

[3]  Nyein Nyein Lwin,et al.  Maternal mortality in 2000: estimates developed by WHO, UNICEF and UNFPA. , 2004 .

[4]  J. Brock,et al.  Blood volume changes and blood loss associated with labor. I. Correlation of changes in blood volume measured by I-131 albumin and Evans blue dye, with measured blood loss. , 1970, American journal of obstetrics and gynecology.

[5]  C. AbouZahr Global burden of maternal death and disability. , 2003, British medical bulletin.

[6]  N. Moss,et al.  Drape estimation vs. visual assessment for estimating postpartum hemorrhage , 2006, International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics.

[7]  S. Paterson–Brown,et al.  Improving the accuracy of estimated blood loss at obstetric haemorrhage using clinical reconstructions , 2006, BJOG : an international journal of obstetrics and gynaecology.

[8]  C. Hobel,et al.  Variations in the Incidence of Postpartum Hemorrhage Across Hospitals in California , 2005, Maternal and Child Health Journal.

[9]  R. McCarthy,et al.  The Accuracy of Blood Loss Estimation After Simulated Vaginal Delivery , 2007 .

[10]  S. Arulkumaran,et al.  Validation of a Laboratory Method of Measuring Postpartum Blood Loss , 1998, Gynecologic and Obstetric Investigation.

[11]  G. Dildy,et al.  Estimating Blood Loss: Can Teaching Significantly Improve Visual Estimation? , 2004, Obstetrics and gynecology.

[12]  Jeani Chang,et al.  Pregnancy-Related Mortality Surveillance — United States , 1991 – 1999 , 2003 .

[13]  C. Berg,et al.  Pregnancy‐Related Mortality in the United States, 1987‐1990 , 1996, Obstetrics and gynecology.

[14]  C. Berg,et al.  Preventability of Pregnancy-Related Deaths: Results of a State-Wide Review , 2005, Obstetrics and gynecology.

[15]  G. Dildy,et al.  Maternal death in the 21st century: causes, prevention, and relationship to cesarean delivery. , 2008, American journal of obstetrics and gynecology.