Training of health professionals through clinical simulation for the management of postpartum hemorrhage: an integrative review
DOI:
https://doi.org/10.5216/ree.v27.77656Keywords:
Simulation Training, Postpartum Hemorrhage, Postpartum PeriodAbstract
Objective: to identify the impact of training health professionals through clinical simulation in managing postpartum hemorrhage. Methods: an integrative review carried out in September 2023, in the LILACS, SciELO, BEDENF, and MEDLINE/PubMed databases, which sought to answer the question “What is the impact of training health professionals through clinical simulation for the management of postpartum hemorrhage?”. The descriptors used were: Postpartum hemorrhage, Simulation Training, and Health Personnel. The Transparent Reporting of Systematic Reviews and Meta-Analyses was used for the screening and selection process, and the Critical Appraisal Skills Program was used to assess methodological rigor, as well as the level of evidence of the selected studies. Results: 13 articles published in international journals in English were included, with a prevalence of level of evidence 3 (n = 9). Simulation training improves professionals' confidence, skills, and knowledge. It also helps to reduce maternal morbidity, increase the use of specific medications, and surgical procedures related to the management of postpartum hemorrhage. Conclusion: clinical simulation training promotes improvements in managing postpartum hemorrhage, favoring a reduction in maternal mortality.
Downloads
References
Tintori JA, Mendes LMC, Monteiro JCS, Gomes-Sponholz F. Epidemiologia da morte materna e o desafio da qualificação da assistência. Acta Paul Enferm. 2022;35:eAPE00251. https://doi.org/10.37689/acta-ape/2022AO00251
Parameshwar PS, Bianco K, Sherwin EB, Meza PK, Tolani A, Bates P, et al. Mixed methods evaluation of simulation-based training for postpartum hemorrhage management in Guatemala. BMC Pregnancy Childbirth. 2022 June 24;22(1):513. https://doi.org/10.1186/s12884-022-04845-2
Organização das Nações Unidas (ONU). Sobre o nosso trabalho para alcançar os objetivos de desenvolvimento sustentável no Brasil [Internet]. c2023. [cited 2023 Oct 26]. Available from: https://brasil.un.org/pt-br/sdgs
Koch DM, Rattmann YD. Use of misoprostol in the treatment of postpartum hemorrhage: a pharmacoepidemiological approach. Einstein. 2019 Oct 29;18:eAO5029. https://doi.org/10.31744/einstein_journal/2020AO5029
World Health Organization (WHO). Trends in maternal mortality 2000 to 2020: Estimates by WHO, UNICEF, UNFPA, World Bank Group and UNDESA/Population Division. Genebra: World Health Organization (WHO). 2023 [cited 2023 Oct 26]. Available from: https://brazil.unfpa.org/sites/default/files/pub-pdf/trends_9789240068759-eng.pdf
Betti T, Gouveia HG, Gasparin VA, Vieira LB, Strada JKR, Fagherazzi J. Prevalência dos fatores de risco para hemorragia pós-parto primária em um hospital universitário. Rev Bras Enferm. 2023 Nov 27;76(5):e20220134. https://doi.org/10.1590/0034-7167-2022-0134pt
Oliveira RC, Davim RMB. Prevenção e tratamento da hemorragia pós-parto. Rev enferm UFPE on line. 2019 Jan 3;13(1):236-48. https://doi.org/10.5205/1981-8963-v13i1a238415p236-248-2019
Castiblanco Montañez RA, Coronado Veloza CM, Morales Ballesteros LV, Polo González TV, Saavedra Leyva AJ. Hemorragia postparto: intervenciones y tratamiento del profesional de enfermería para prevenir shock hipovolémico. Revista Cuidarte. 2022 Mar 15;13(1):e2075. https://doi.org/10.15649/cuidarte.2075
Andrade PON, Oliveira SC, Morais SCRV, Guedes TG, Melo GP, Linhares FMP. Validation of a clinical simulation setting in the management of postpartum haemorrhage. Rev Bras Enferm. 2019 June 27;72(3):624-31. https://doi.org/10.1590/0034-7167-2018-0065
Flausino DA, Oliveira AR, Misko MD, Eduardo AHA. Cenário para treinamento por simulação sobre comunicação de notícias difíceis: um estudo de validação. Esc Anna Nery. 2021 Oct 25;26:e20210037. https://doi.org/10.1590/2177-9465-EAN-2021-00370
Souza MT, Silva MD, Carvalho R. Integrative review: what is it? How to do it? Einstein (São Paulo). 2010 Jan-Mar;8(1):102-6. https://doi.org/10.1590/S1679-45082010RW1134
Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JPA, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med. 2009 July 21;6(7):e1000100. https://doi.org/10.1371/journal.pmed.1000100
Ursi ES, Gavão CM. Prevenção de lesões de pele no perioperatório: revisão integrativa da literatura. Rev Latino-Am. Enfermagem. 2006 Mar 8;14(1):124-31. https://doi.org/10.1590/S0104-11692006000100017
Critical Appraisal Skills Programme. Critical appraisal checklist [Internet]. Oxford;c2023 [cited 2023 June 3]. Available from: http://www.casp-uk.net/casp-tools-checklists
Fineout-Overholt E, Melnyk BM, Stillwell SB, Williamson KM. Evidence-Based Practice Step By Step: Critical Appraisal of the Evidence: Part I. Am J Nurs. 2010;110(7):47-52. https://doi.org/10.1097/01.naj.0000383935.22721.9c
Siaulys MM, Cunha LB, Torloni MR, Kondo MM. Obstetric emergency simulation training course: experience of a private-public partnership in Brazil. Reprod Health. 2019 Feb 27;16:24. https://doi.org/10.1186/s12978-019-0689-6
Ramseyer AM, Lutgendorf MA. Implementation of Low-Cost obstetric hemorrhage simulation training models for resident education. Mil Med. 2019 Apr 30;184(11-12):e637-41. https://doi.org/10.1093/milmed/usz098
Hernández E, Camacho M, Leal-Costa C, Ruzafa-Martínez M, Ramos-Morcillo AJ, Cazorla E, et al. Does multidisciplinary team simulation-based training improve obstetric emergencies skills? Healthcare. 2021 Feb 5;9(2):170. https://doi.org/10.3390/healthcare9020170
Meza PK, Bianco K, Herrarte E, Daniels K. Changing the landscape of obstetric resident education in low and middle-income countries using simulation-based training. Int J Gynaecol Obstet. 2020 Dec 12;154(1):72-8. https://doi.org/10.1002/ijgo.13526
Changuiti O, Moustarhfir N, Marfak A, Saad E, Hilali A, Youlyouz-Marfak I. Simulation based-learning from simple to complicated clinical situations for midwifery students. Adv Med Educ Pract. 2021 Aug 12;12:881-6. https://doi.org/10.2147/amep.s318560
Sumner E, Craig C, Coleman J, Kumi H, Scott H. Low-fidelity simulation for management of postpartum haemorrhage in a Ghanaian teaching hospital. Afr J Reprod Health [Internet]. 2022 Apr [Internet];26(4):57-64. Available from: https://www.ajrh.info/index.php/ajrh/article/view/3289
Michelet D, Barré J, Job A, Truchot J, Cabon P, Delgoulet C, et al. Benefits of screen-based postpartum hemorrhage simulation on nontechnical skills training: a randomized simulation study. Simul Healthc. 2019 Dec;14(6):391-7. https://doi.org/10.1097/sih.0000000000000395
Dillon SJ, Kleinmann W, Fomina Y, Werner B, Schultz S, Klucsarits S, et al. Does simulation improve clinical performance in management of postpartum hemorrhage. Am J Obstet Gynecol. 2021 Oct;225(4):435.e1-8. https://doi.org/10.1016/j.ajog.2021.05.025
Lutgendorf MA, Ennen CS, McGlynn A, Spalding CN, Deering S, Delorey DR, et al. Interprofessional obstetric simulation training improves postpartum haemorrhage management and decreases maternal morbidity: a before-and-after study. BJOG. 2023 Aug 14;131(3):353-61. https://doi.org/10.1111/1471-0528.17640
Baldvinsdóttir T, Blomberg M, Lilliecreutz C. Improved clinical management but not patient outcome in women with postpartum haemorrhage-An observational study of practical obstetric team training. PLoS One. 2018 Sept 26;13(9):e0203806. https://doi.org/10.1371/journal.pone.0203806
Melo BCP, Van der Vleuten CPM, Muijtjens AMM, Falbo AR, Katz L, Van Merriënboer JJG, et al. Effects of an in situ instructional design based postpartum hemorrhage simulation training on patient outcomes: an uncontrolled before-and-after study. J Matern Fetal Neonatal Med. 2019 Apr 25;34(2):245-52. https://doi.org/10.1080/14767058.2019.1606195
Gerard JL, Turrentine MA, Leong-Kee S. Reducing hemorrhage-related maternal morbidity using interdisciplinary simulation training. Simul Healthc. 2024 Feb;19(1):21-6. https://doi.org/10.1097/sih.0000000000000702
Malfussi LBH, Nascimento ERP, Lazzari DD, Hermida PMV, Martini JG, Silva CCR. Simulação in situ com a equipe de enfermagem de terapia intensiva: relato de experiência. Enferm Foco. 2023 Apr 25;14:e-202314. https://doi.org/10.21675/2357-707X.2023.v14.e-202314
Organização Pan-Americana da Saúde (OPAS); Organização Mundial da Saúde (OMS). Recomendações assistenciais para prevenção, diagnóstico e tratamento da hemorragia obstétrica [internet]. Brasília: OPAS: OMS; 2018 [cited 2023 July 17]. Available from: https://iris.paho.org/handle/10665.2/34879
Hemorragia pós-parto: prevenção, diagnóstico e manejo não cirúrgicos [Internet]. Femina. 2020 Nov [cited 2023 July 17];48(11):671-9. Available from: https://docs.bvsalud.org/biblioref/2020/12/1140183/femina-2020-4811-671-679.pdf
Vieira SN, Vidigal BAA, Inácio AS, Norte AS, Vasconcelos MNG. Avaliação da assistência de enfermagem na hemorragia pós-parto. Rev enferm UFPE on line. 2018 Dec 2;12(12):3247-53. https://doi.org/10.5205/1981-8963-v12i12a236179p3247-3253-2018
Practice bulletin No. 183: postpartum hemorrhage. Obstet Gynecol. 2017 Oct;130(4):e168-86. https://doi.org/10.1097/aog.0000000000002351
Rockenbach GM, Vaz LHS, Cunha LASM, Braga NB. Tratamento farmacológico da hemorragia pós-parto: uma revisão dos principais guidelines da literatura [monograph on the Internet]. [Vespasiano]: Faculdade da Saúde e Ecologia Humana – FASEH; 2022 [cited 2023 Out 27]. Available from: https://repositorio.animaeducacao.com.br/handle/ANIMA/27055
Stocker J, Faria L. Competência percebida no ensino secundário: do conceito à avaliação através de um questionário compósito. Psicologia. 2012;26(2):113-40. https://doi.org/10.17575/rpsicol.v26i2.273
Bento SF, Borovac-Pinheiro A, Tanaka EZ, Silveira C, Pacagnella RC. Understanding how health providers identify women with postpartum hemorrhage: a qualitative study. Rev Bras Ginecol Obstet. 2021 Nov 29;43(9):648-654. https://doi.org/10.1055/s-0041-1733997
Dillard AC. Obstetric hemorrhage in the rural emergency department: rapid response. J Emerg Nurs. 2017 Jan;43(1):15-20. https://doi.org/10.1016/j.jen.2016.10.002
Rangel RCT, Souza ML, Bentes CML, Souza ACRH, Leitão MNC, Lynn FA. Tecnologias de cuidado para prevenção e controle da hemorragia no terceiro estágio do parto: revisão sistemática. Rev Latino-Am Enfermagem. 2019 Aug 19;27:e3165. https://doi.org/10.1590%2F1518-8345.2761.3165
Ferreira ASCG, Mazzafera BL, Bianchini LGB. O Uso da simulação na formação do médico brasileiro: uma revisão da literatura. Rev. Ens. Educ. Cienc. Hum [Internet]. 2023 Jan 26 [cited 2023 Out 27];23(5):723-31. Available from: https://revistaensinoeeducacao.pgsscogna.com.br/ensino/article/view/10382
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Revista Eletrônica de Enfermagem

This work is licensed under a Creative Commons Attribution 4.0 International License.












