Clinical risk management in obstetrics: eclampsia drills*
- 1Department of Anaesthetics, St George Hospital, Kograh 2217 Sydney, Australia
- 2St John’s Hospital, Livingston, West Lothian EH54 6PP, UK
- 3Royal Infirmary of Edinburgh, Edinburgh EH3 9YW, UK
- Correspondence to: S Thompson Department of Anaesthetics, St George Hospital, Kograh 2217 Sydney, Australia; sarahathompsonhotmail.com
Abstract
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.
Footnotes
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↵* This is a reprint of a quality improvement report that appeared in the BMJ, 2004, , pages –71.
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Funding: None declared.
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Competing interests: None declared.
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Contributors: ST has participated in and coordinates drills, and initiated this article. SN is the lead obstetric anaesthetist in a district hospital, coordinates drills in her unit, and provided the photograph. VC initiated and organises the obstetric emergency drills programme at the Simpson Centre for Reproductive Health, Royal Infirmary of Edinburgh.
