Interactive Shoulder Dystocia Simulation Training Impact on Staff Safety Attitudes and Preparedness

Abstract

Shoulder dystocia is a rare yet critical obstetric emergency associated with significant maternal and neonatal complications. Effective management is key to reducing risks like brachial plexus palsy, clavicle fractures, and brain injury. In the United States, shoulder dystocia is uncommon, occurring in approximately 23 out of 1,000 deliveries. Obstetric teams rely on simulation training to prepare staff for this clinical emergency. This quality improvement project employed a pretest-posttest design within the Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS®) framework to investigate the impact of the AHRQ Shoulder Dystocia simulation training on clinical staff performance. The study involved 22 labor and delivery staff, measuring outcomes before and after the intervention using the Safety Attitudes Questionnaire and the AHRQ Shoulder Dystocia Simulation Assessment Tool. Results showed significant improvements in Teamwork and Safety Climate (g=.93-.98), and medium improvements in areas such as Job Satisfaction and Stress Recognition (g=.51 to .58). Key behaviors such as communication, team support, and debriefing showed substantial improvement (Cohen’s h=1.46). Routine multidisciplinary simulation training continues to play a crucial role in ensuring safe and effective management of shoulder dystocia.

Disciplines

Nursing | Obstetrics and Gynecology

Subject Area

Nursing; Obstetrics; Health care management

Department

Nursing (NUR)

First Advisor

Stager, Sharon

Second Advisor

Krampen, Olivia

Date of Award

2025

Document Type

Dissertation

Degree Name

D.N.P.

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