Effects of Systematic Cervical Exam Training on Labor and Delivery Care

Not Applicable

Recruiting

Brief Summary: All physicians, nurses, and nurse midwives working on Labor and Delivery will be required to complete cervical exam simulation training. Data before and after institution of the training will be compared to determine if the training leads to less cervical exams during labor and increases consistency between examiners

Detailed Description: The labor cervical exam is the cornerstone of the management of labor as the accurate assessment of cervical dilation and effacement are crucial in recognizing a normal labor from and abnormal one. To enhance accuracy and precision among healthcare providers working on Labor and Delivery we have created a high fidelity cervical exam simulator. All providers working on Labor and Delivery Repetitive will be required to practice on the simulators until a pre-specified level or accuracy is achieved. We will prospectively and retrospectively assess the number of cervical exams a women receives and the discrepancy between exams performed by 2 different providers both before and after the training is instituted.

Recruitment & Eligibility

Inclusion Criteria

Healthcare providers:

• physicians, midwives, and labor and delivery nurses working on the Labor and Delivery unit within the Wake Forest Baptist Birth Center

Patients:

• any pregnant women receiving care on the Labor and Delivery unit of Wake Forest Baptist Birth Center

Exclusion Criteria

Healthcare providers:

• none

Patients:

Arm && Interventions

Group	Intervention	Description
systematic cervical exam training--retrospective measures	cervical exam training	Effects of systematic cervical exam training on Labor and Delivery Care The total number of exams per hour of labor or triage stay and exam discrepancy between 2 examiners who performed exams less than 30 minutes apart will be compared between the 6 month time period before the unit wide training and 6 months after completing training
systematic cervical exam training--prospective measures	cervical exam training	Effects of systematic cervical exam training on Labor and Delivery care Patient will be approached to obtain consent for them to have 2 cervical exams performed one after the other when an exam is clinically indicated. The discrepancy between the 2 examiners will be compared between the 6 month time period before the unit wide training and 6 months after completion of the training.

Primary Outcome Measures

Name	Time	Method
Number of repetitions needed to obtain competence	3 month training period	The number of simulated cervical exams each provider needs to reach a pre-specified level of accuracy.
Number of exams patients receive	Six month post training	Number of exams per hour of labor or triage visit

Secondary Outcome Measures

Name	Time	Method
Discrepancy between 2 cervical exam assessments--retrospective	Six months period before training and Six months period post training completion	Discrepancy between 2 exam assessments performed less than 30 minutes apart by 2 different examiners: Cervix Dilation will be reported as 1-10 cm Cervix Effacement will be reported as 0% -100%
Discrepancy between 2 cervical exam assessments--prospective	Six months period before training and Six months period post training completion	Discrepancy between 2 exam assessments performed one after the other by 2 different examiners: Cervix Dilation will be reported as 1-10 cm Cervix Effacement will be reported as 0% -100%

Locations (1): Wake Forest University Health Sciences
🇺🇸
Winston-Salem, North Carolina, United States

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