{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T18:51:47Z","timestamp":1778871107980,"version":"3.51.4"},"reference-count":42,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2022,6,13]],"date-time":"2022-06-13T00:00:00Z","timestamp":1655078400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1112431"],"award-info":[{"award-number":["OPP1112431"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["gatesopenresearch.org"],"crossmark-restriction":false},"short-container-title":["Gates Open Res"],"abstract":"<ns4:p>\n                    <ns4:bold>Background<\/ns4:bold>\n                    : Mentoring programs that include simulation, bedside\n                  <\/ns4:p>\n                  <ns4:p>mentoring, and didactic components are becoming increasingly<\/ns4:p>\n                  <ns4:p>popular to improve quality. These programs are designed with little<\/ns4:p>\n                  <ns4:p>evidence to inform the optimal composition of mentoring activities that<\/ns4:p>\n                  <ns4:p>would yield the greatest impact on provider skills and patient<\/ns4:p>\n                  <ns4:p>outcomes. We examined the association of number of maternal and<\/ns4:p>\n                  <ns4:p>neonatal emergency simulations performed in trainings with the diagnosis of<\/ns4:p>\n                  <ns4:p>postpartum hemorrhage (PPH) and intrapartum asphyxia in real<\/ns4:p>\n                  <ns4:p>patients.<\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Methods<\/ns4:bold>\n                    : We used a prospective cohort and births were compared between- and within-facility over time.\n                  <\/ns4:p>\n                  <ns4:p>Setting included 320 public<\/ns4:p>\n                  <ns4:p>facilities in the state of Bihar, India May 2015 \u2013 2017. The participants<\/ns4:p>\n                  <ns4:p>were Deliveries and livebirths. The interventions carried out were<\/ns4:p>\n                  <ns4:p>mobile nurse-mentoring program with simulations, teamwork and<\/ns4:p>\n                  <ns4:p>communication activities, didactic teaching, demonstrations of clinical<\/ns4:p>\n                  <ns4:p>procedures and bedside mentoring including conducting deliveries.<\/ns4:p>\n                  <ns4:p>Nurse mentor pairs visited each facility for one week, covering four<\/ns4:p>\n                  <ns4:p>facilities over a four-week period, for seven to nine consecutive<\/ns4:p>\n                  <ns4:p>months. The outcome measures were diagnosis of PPH and<\/ns4:p>\n                  <ns4:p>intrapartum asphyxia.<\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Results<\/ns4:bold>\n                    : Relative to the bottom\u00a0one-third facilities that performed the\n                  <\/ns4:p>\n                  <ns4:p>fewest maternal simulations, facilities in the middle one-third group<\/ns4:p>\n                  <ns4:p>diagnosed 26% (incidence rate ratio [IRR] = 1.26, 95% confidence<\/ns4:p>\n                  <ns4:p>interval [CI]: 1.00, 1.59) more cases of PPH in real patients. Similarly,<\/ns4:p>\n                  <ns4:p>facilities in the middle one-third group, diagnosed 25% (IRR = 1.25,<\/ns4:p>\n                  <ns4:p>95% CI: 1.04, 1.50) more cases of intrapartum asphyxia relative to the<\/ns4:p>\n                  <ns4:p>bottom third group that did the fewest neonatal simulations.\u00a0Facilities<\/ns4:p>\n                  <ns4:p>in the top one-third group (i.e., performed the most simulations) did<\/ns4:p>\n                  <ns4:p>not have a significant difference in diagnosis relative the bottom one-third group.<\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Conclusions<\/ns4:bold>\n                    : Findings suggest a complex relationship between\n                  <\/ns4:p>\n                  <ns4:p>performing simulations and opportunities for direct practice with<\/ns4:p>\n                  <ns4:p>patients, and there may be an optimal balance in performing the two<\/ns4:p>\n                  <ns4:p>that would maximize diagnosis of PPH and intrapartum asphyxia.<\/ns4:p>","DOI":"10.12688\/gatesopenres.13490.1","type":"journal-article","created":{"date-parts":[[2022,6,13]],"date-time":"2022-06-13T05:50:30Z","timestamp":1655099430000},"page":"70","update-policy":"https:\/\/doi.org\/10.12688\/gatesopenres.crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Simulation and nurse-mentoring in a statewide nurse mentoring program in Bihar, India: diagnosis of postpartum hemorrhage and intrapartum 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The funding body had no role in study design, data collection, analysis, interpretation, manuscript writing, or the decision to submit the manuscript for publication. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":3,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}