Clinical risk management in obstetrics: eclampsia drills

Sarah Thompson, Shona Neal, Vicki Clark
BMJ: British Medical Journal 2004 January 31, 328 (7434): 269-71

PROBLEM: Infrequent presentation of patients with eclampsia, leading to staff inexperienced in the condition and untested emergency systems.

DESIGN: "Fire drill" programme using on-site simulation of patients with eclampsia.

SETTING: Tertiary referral obstetric unit.

KEY MEASURES FOR IMPROVEMENT: Successful implementation of measures to optimise management of eclampsia.

STRATEGIES FOR CHANGE: Rapid activation of emergency team after one call, development and dissemination of evidence based protocol for eclampsia, strategically placed "eclampsia boxes," individual staff feedback and education.

EFFECTS OF CHANGE: Efficient and appropriate management of subsequent simulated patients.

LESSONS LEARNT: On-site simulation can identify and correct potential deficiencies in the care of patients with eclampsia.

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