Efficacy of an ultrasound training program for nurse midwives to assess high-risk conditions at labor triage in rural Uganda

• DOI: 10.1371/journal.pone.0235269
• Publication Date: 2020-06-30T19:51:09Z
• Authors: Sachita Shah; Nicole Santos; Rose Kisa; Odida Mike Maxwell; Jude Mulowooza; Dilys Walker; Krithika Meera Mu...
• Keywords: Debriefing; Triage

Many high-risk conditions of pregnancy are undetected until the time delivery in low-income countries. We developed a point-of-care ultrasound training protocol for providers rural Uganda to detect fetal distress or demise, malpresentation, multiple gestation, placenta previa, oligohydramnios and preterm delivery. This was mixed-methods study evaluate 2-week curriculum trainees' ability perform standard scanning interpret images. Surveys assess provider confidence were administered pre-training, immediately after, at 3-month follow up. Following lecture practical demonstrations, each trainee conducted 25 proctored scans required pass an observed structured clinical exam (OSCE). All images produced 8 weeks post course underwent blinded review by two experts image quality identify common errors. Key informant interviews further assessed perceptions program utility ultrasound. audio recorded, transcribed, reviewed readers using content analysis approach. Twenty-three nurse/nurse midwives physicians from one district hospital three health centers participated curriculum. Confidence levels increased average 1 point pre-course over 6 points post-course all measures (maximum 7 points). Of participants, 22 passed OSCE on first attempt (average score 89.4%). Image improved time; final error rate week less than 5%, with overall kappa 0.8–1 between reviewers. Among 12 key conducted, themes included desire more hands-on longer duration challenges balancing duties attend sessions. demonstrates that without previous experience can during labor high accuracy after training.