Simulation-enhanced nurse mentoring to improve preeclampsia and eclampsia care: an education intervention study in Bihar, India

Table 2 Proportion of simulated preeclampsia and eclampsia cases in which nurse mentees completed key history, diagnostic, and management steps (N = 39 matched pairs)

	First simulation	Last simulation
History questions	n (%)^§		p-value
Headache	28 (71.8)	32 (82.1)	0.25^‡
Blurry vision	17 (43.6)	20 (51.3)	0.49^‡
Epigastric pain	1 (2.6)	7 (17.9)	0.01^‡
Asks gestational age	8 (20.5)	12 (30.8)	0.14^‡
Total steps completed (median, IQR^*)	1.0 (1.0–2.0)	2.0 (1.0–2.0)	0.03^∞
Diagnostic tests
BP assessed	39 (100.0)	39 (100.0)	NA
FHR assessed	29 (74.4)	30 (76.9)	0.08^‡
Fundal height measured	3 (7.7)	7 (17.9)	0.15^‡
Clonus or DTR	9 (23.1)	6 (15.4)	0.44^‡
Edema	8 (20.5)	12 (30.8)	0.30^‡
Urine protein test	12 (30.8)	11 (28.2)	0.80^‡
Total steps completed (median, IQR^*)	3.0 (2.0–3.0)	3.0 (2.0–3.0)	0.39^∞
Management steps
Magnesium sulfate given	33 (86.4)	32 (82.1)	0.74^‡
Antihypertensive given	22 (56.4)	28 (71.8)	0.20^‡
Intravenous catheter placed	16 (41.0)	24 (61.5)	0.08^‡
Foley catheter inserted	15 (38.5)	22 (56.4)	0.06^‡
Total steps completed (median, IQR^*)	2.0 (1.5–3.0)	3.0 (2.0–4.0)	0.03^∞
Airway management steps (N = 13 matched pairs^{^})
Oxygen given	9 (34.6)	9 (34.6)	NA
Patient repositioned	19 (73.1)	17 (65.4)	0.56^‡
Total steps completed (median, IQR^*)	1.0 (0.25–2.0)	1.0 (0.25–1.75)	0.71^∞

^§n = Frequency of first and last simulated cases in which mentees completed key EBPs
% = Proportion of first and last simulated cases in which mentees completed key EBPs
^*IQR = interquartile range of total number of steps completed
^#Difference in proportion of EBPs completed from first to last participation in simulated case
^‡GEE logistic regression adjusted for duration (in days) between first and last simulations
^∞GEE linear regression adjusted for duration (in days) between first and last simulations
^{^}Airway management steps analyzed in simulated eclampsia cases only

ISSN: 1471-2393