Multidisciplinary team training reduces the decision-to-delivery interval for emergency Caesarean section.

Abstract

Emergency Caesarean section is performed when the life of the pregnant woman and/or the foetus is considered at risk. A 30-min standard for the decision-to-delivery interval (DDI) is a common practice and is supported by national organisations including The Danish Society of Obstetrics and Gynaecology. Danish obstetric departments report the DDI to a national database. A national arbitrarily set standard recommends that 95% of ECSs should be achieved within the 30-min DDI standard. In 2011, 34.4% of ECSs, performed at our hospital, were achieved within the 30-min time frame. This study aims to evaluate the effect of a simulation-based team training programme on the proportion of ECSs achieved within a 30-min time frame. We performed an interventional before-and-after study. We evaluated a total of one hundred 30-min ECSs before and after the intervention. The primary outcome of interest was the proportion of 30-min ECSs achieved within a 30-min time frame. A total of 20 team training courses were held during May/June 2013. These courses trained 239 of 252 team members (comprised of: 36 obstetricians, 45 scrub nurses, 83 midwives, 38 anaesthesiologists, 37 nurse anaesthetists) in handling of 30-min ECS. This corresponds to 95% of staff. The proportion of 30-min ECSs achieved within a 30-min time frame was higher after team training (87.5%, 95% CI 79.2-93.4%) compared with before training (74.0%, 95% CI 64.0-82.4%) (P = 0.017). Team training may contribute positively to an increase in the proportion of ECSs achieved within a 30-min time frame.