• Login
    View Item 
    •   Home
    • Hospital Research
    • Leinster
    • Tallaght University Hospital
    • View Item
    •   Home
    • Hospital Research
    • Leinster
    • Tallaght University Hospital
    • View Item
    JavaScript is disabled for your browser. Some features of this site may not work without it.

    Map of Submissions

    Home Page
    UlsterN
    4715
    UlsterS
    4715
    Connacht
    1603
    Munster
    48
    Leinster
    426

    Browse

    All of Lenus, The Irish Health RepositoryCommunitiesTitleAuthorsDate publishedSubjectsThis CollectionTitleAuthorsDate publishedSubjects

    My Account

    LoginRegister

    About

    About LenusDirectory of Open Access JournalsOpen Access Publishing GuideNational Health Library & Knowledge ServiceGuide to Publishers' PoliciesFAQsTerms and ConditionsVision StatementRIAN Pathways to Irish ResearchHSE position statement on Open AccessNational Open Research Forum (NORF)Zenodo (European Open Research repository)

    Statistics

    Display statistics

    Proficiency-based progression training: an 'end to end' model for decreasing error applied to achievement of effective epidural analgesia during labour: a randomised control study.

    • CSV
    • RefMan
    • EndNote
    • BibTex
    • RefWorks
    Thumbnail
    Name:
    e020099.full.pdf
    Size:
    504.4Kb
    Format:
    PDF
    Download
    Authors
    Kallidaikurichi Srinivasan, Karthikeyan
    Gallagher, Anthony
    O'Brien, Niall
    Sudir, Vinod
    Barrett, Nick
    O'Connor, Raymund
    Holt, Francesca
    Lee, Peter
    O'Donnell, Brian
    Shorten, George
    Issue Date
    2018-10-15
    Keywords
    anaesthesia
    medical education and training
    simulation
    ANALGESIA
    CHILDBIRTH
    MEDICAL EDUCATION AND TRAINING
    
    Metadata
    Show full item record
    URI
    http://hdl.handle.net/10147/626945
    DOI
    10.1136/bmjopen-2017-020099
    PubMed ID
    30327396
    Abstract
    Background: Training procedural skills using proficiency-based progression (PBP) methodology has consistently resulted in error reduction. We hypothesised that implementation of metric-based PBP training and a valid assessment tool would decrease the failure rate of epidural analgesia during labour when compared to standard simulation-based training. Methods: Detailed, procedure-specific metrics for labour epidural catheter placement were developed based on carefully elicited expert input. Proficiency was defined using criteria derived from clinical performance of experienced practitioners. A PBP curriculum was developed to train medical personnel on these specific metrics and to eliminate errors in a simulation environment.Seventeen novice anaesthetic trainees were randomly allocated to undergo PBP training (Group P) or simulation only training (Group S). Following training, data from the first 10 labour epidurals performed by each participant were recorded. The primary outcome measure was epidural failure rate. Results: A total of 74 metrics were developed and validated. The inter-rater reliability (IRR) of the derived assessment tool was 0.88. Of 17 trainees recruited, eight were randomly allocated to group S and six to group P (three trainees did not complete the study). Data from 140 clinical procedures were collected. The incidence of epidural failure was reduced by 54% with PBP training (28.7% in Group S vs 13.3% in Group P, absolute risk reduction 15.4% with 95% CI 2% to 28.8%, p=0.04). Conclusion: Procedure-specific metrics developed for labour epidural catheter placement discriminated the performance of experts and novices with an IRR of 0.88. Proficiency-based progression training resulted in a lower incidence of epidural failure compared to simulation only training.
    Item Type
    Article
    Language
    en
    ISSN
    2044-6055
    ae974a485f413a2113503eed53cd6c53
    10.1136/bmjopen-2017-020099
    Scopus Count
    Collections
    Tallaght University Hospital

    entitlement

    Related articles

    • Early versus late initiation of epidural analgesia for labour.
    • Authors: Sng BL, Leong WL, Zeng Y, Siddiqui FJ, Assam PN, Lim Y, Chan ES, Sia AT
    • Issue date: 2014 Oct 9
    • Spinal ultrasound versus palpation for epidural catheter insertion in labour: A randomised controlled trial.
    • Authors: Arzola C, Mikhael R, Margarido C, Carvalho JC
    • Issue date: 2015 Jul
    • A Proficiency-Based Progression Training Curriculum Coupled With a Model Simulator Results in the Acquisition of a Superior Arthroscopic Bankart Skill Set.
    • Authors: Angelo RL, Ryu RK, Pedowitz RA, Beach W, Burns J, Dodds J, Field L, Getelman M, Hobgood R, McIntyre L, Gallagher AG
    • Issue date: 2015 Oct
    • Continuous epidural infusion vs programmed intermittent epidural bolus for labour analgesia: a prospective, controlled, before-and-after cohort study of labour outcomes.
    • Authors: Bullingham A, Liang S, Edmonds E, Mathur S, Sharma S
    • Issue date: 2018 Aug
    • Position in the second stage of labour for women with epidural anaesthesia.
    • Authors: Kibuka M, Thornton JG
    • Issue date: 2017 Feb 24
    National Health Library & Knowledge Service | Health Service Executive | Dr Steevens' Hospital | Dublin 8 | Ireland
    lenus@hse.ie | Tel +353 (1) 6352558
    DSpace software copyright © 2002-2017  DuraSpace
    Contact Us | Disclaimer
    Open Repository is a service operated by 
    Atmire NV
     

    Export search results

    The export option will allow you to export the current search results of the entered query to a file. Different formats are available for download. To export the items, click on the button corresponding with the preferred download format.

    By default, clicking on the export buttons will result in a download of the allowed maximum amount of items.

    To select a subset of the search results, click "Selective Export" button and make a selection of the items you want to export. The amount of items that can be exported at once is similarly restricted as the full export.

    After making a selection, click one of the export format buttons. The amount of items that will be exported is indicated in the bubble next to export format.