Evaluation of an international educational programme for health care professionals on best practice in the management of a perinatal death: IMproving Perinatal mortality Review and Outcomes Via Education (IMPROVE)
Evaluation of an international educational programme for health care professionals on best practice in the management of a perinatal death: IMproving Perinatal mortality Review and Outcomes Via Education (IMPROVE)
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DOI：
10.1186/s12884-016-1173-8
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发表时间：
2016-11-25
影响因子：
3.1
通讯作者：
Flenady, Vicki
中科院分区：
文献类型：
--
作者：
Gardiner, Paul A.;Kent, Alison L.;Flenady, Vicki
背景：死产和新生儿死亡对父母和临床医生都是毁灭性的事件，是全球公共卫生问题。需要在这些死亡后进行仔细的临床管理，包括适当的调查和评估，以确定死亡原因(S)，以防止未来的损失，并改善对家属的丧亲护理。根据澳大利亚和新西兰围产期协会的围产期死亡率指南：通过教育改善围产期死亡率审查和结果，为从事孕产妇和儿童健康工作的卫生保健专业人员设计了一项教育方案，以满足这些需求。该方案以死产为主要重点，以六个互动式技能电台的形式提供。我们的目标是确定参与者在计划前和计划后对围产期死亡管理的知识和信心，以及对计划的满意度。我们还旨在确定是否适合在国际上使用。方法：在澳大利亚所有七个州和地区的妇产科医院的卫生专业人员中进行了改进，并在越南、斐济和荷兰(在国际死胎联盟的协助下)进行了修改，以便在国际上使用。与当地小组协商，对方案材料进行了修改，其中包括越南方案的翻译。结果：2012年5月至2015年5月期间，共举办了30个改进讲习班，其中澳大利亚26个，参加人数758人，国际参加4个，参加人数136人。评价表明，在所有六个站点和总体上，方案实施前和方案后的知识和信心都有了显著的改善，在所有环境中都获得了高度的满意。需要未来的研究来确定知识的直接改善是否持续，较少的死亡原因被归类为未知、临床实践的变化和父母护理经验的改善。还需要确定这一方案在低收入国家的适宜性。
Background: Stillbirths and neonatal deaths are devastating events for both parents and clinicians and are global public health concerns. Careful clinical management after these deaths is required, including appropriate investigation and assessment to determine cause (s) to prevent future losses, and to improve bereavement care for families. An educational programme for health care professionals working in maternal and child health has been designed to address these needs according to the Perinatal Society of Australia and New Zealand Guideline for Perinatal Mortality: IMproving Perinatal mortality Review and Outcomes Via Education (IMPROVE). The programme has a major focus on stillbirth and is delivered as six interactive skills-based stations. We aimed to determine participants' pre- and post-programme knowledge of and confidence in the management of perinatal deaths, along with satisfaction with the programme. We also aimed to determine suitability for international use.Methods: The IMPROVE programme was delivered to health professionals in maternity hospitals in all seven Australian states and territories and modified for use internationally with piloting in Vietnam, Fiji, and the Netherlands (with the assistance of the International Stillbirth Alliance, ISA). Modifications were made to programme materials in consultation with local teams and included translation for the Vietnam programme. Participants completed pre-and post-programme evaluation questionnaires on knowledge and confidence on six key components of perinatal death management as well as a satisfaction questionnaire.Results: Over the period May 2012 to May 2015, 30 IMPROVE workshops were conducted, including 26 with 758 participants in Australia and four with 136 participants internationally. Evaluations showed a significant improvement between pre- and post-programme knowledge and confidence in all six stations and overall, and a high degree of satisfaction in all settings.Conclusions: The IMPROVE programme has been well received in Australia and in three different international settings and is now being made available through ISA. Future research is required to determine whether the immediate improvements in knowledge are sustained with less causes of death being classified as unknown, changes in clinical practice and improvement in parents' experiences with care. The suitability for this programme in low-income countries also needs to be established.