PRONTO: Obstetric and Neonatal Emergency Training Program: A Cluster-Randomized Trial to Measure Impact

Conditions

Pregnancy Related Complications

Keywords

Women, Maternal morbidity, Maternal mortality, Perinatal mortality, Perinatal morbidity, Training, Obstetric Emergency, Medical team, Simulation

Brief summary

Rates and causes of maternal mortality in Mexico have dropped only slightly; thus, reaching the internationally established Millennium Development Milestones (MDM) is still a distant goal. A fundamental part of reducing maternal and infant mortality is ensuring an adequate and timely response to obstetric emergencies. PRONTO2: Obstetric and Neonatal Emergency Training Program is an innovative training strategy based on simulations designed to train hospital personnel to respond to obstetric emergencies. The objective of this study is to implement PRONTO2 in selected hospitals to measure the effectiveness of the intervention in influencing key behaviors in hospital practices, as well as measuring maternal and neonatal outcomes in intervention versus control hospitals.

Jimena Fritz

UNC Libraries2019-08-18

10.17615/v5xr-cj37

Health providers pass knowledge and abilities acquired by training in obstetric emergencies to their peers: the average treatment on the treated effect of PRONTO on delivery attendance in Mexico.

Fritz J, Lamadrid-Figueroa H, Angeles G, Montoya A, Walker D.

2018-06-156 citations

10.1186/s12884-018-1872-4

Can a simulation-based training program impact the use of evidence based routine practices at birth? Results of a hospital-based cluster randomized trial in Mexico.

Fritz J, Walker DM, Cohen S, Angeles G, Lamadrid-Figueroa H.

2017-03-2021 citations

10.1371/journal.pone.0172623

Team training in obstetric and neonatal emergencies using highly realistic simulation in Mexico: impact on process indicators.

Walker D, Cohen S, Fritz J, Olvera M, Lamadrid-Figueroa H, Cowan JG, Hernandez DG, Dettinger JC, Fahey JO.

2014-11-2058 citations

10.1186/s12884-014-0367-1

Interventions

OTHERPRONTO training

PRONTO is an intervention consisting of two training modules for medical professionals. Module 1 is delivered over 2-3 days, takes place in the hospital, and consists of high-fidelity, low-tech simulations. The curriculum employs elements of the Team STEPPS program to strengthen teamwork and leadership skills, and the use of effective communication techniques. The activities and simulations have clear objectives and use evidenced-based medical concepts. Module 2, the follow-up training, uses the same teaching methodology as Module 1 to reinforce teamwork, communication, and emergency response skills, and incorporates new topics such as preeclampsia /eclampsia, shoulder dystocia and pelvic presentation.

Study design

Allocation

RANDOMIZED

Intervention model

PARALLEL

Primary purpose

SUPPORTIVE_CARE

Masking

SINGLE (Outcomes Assessor)

Eligibility

Healthy volunteers

No

Inclusion criteria

* Hospitals must be located in Guerrero, Chiapas, or Mexico states * Number of deliveries and cesareans was between 500 and 3000 in 2009

Exclusion criteria

* Inaccessible by car

Design outcomes

Primary

Measure	Time frame	Description
Perinatal mortality	12 months	Assess perinatal mortality over the 12 month period following the training intervention

Secondary

Measure	Time frame	Description
Serious maternal complications	12 months	Assess the number of serious obstetric complications over 12 months following training intervention
Death rate from obstetric hemorrhage	12 months	Number of deaths from obstetric hemorrhage/total number of obstetric hemorrhages
Death rate from preeclampsia/eclampsia	12 months	Number of deaths from preeclampsia/eclampsia / totaly number of preeclampsia/eclampsia cases

Outcome results

None listed