There are several risk factors that might have led to the primary problem experienced by the patient. One of the risk factors from the history given is the induction using oxytocin. Oxytocin being a drug used for induction leads to hyper contractility of the uterus. This makes the uterus to contract too much and affects the normal contraction of the uterus. This might have caused the uterine walls to fracture leading to the bleeding after the delivery.
Another issue that might have caused too much bleeding is what is termed as multiparity. This is where a person has delivered more than one offspring. This leads to overstretching of the uterus and thus makes the subsequent deliveries problematic. In this case, the lady had three kids before. The fourth pregnancy might have been complicated due to overstretching of the uterus which causes bleeding(Heilmann, Wild, Hojnacki, & Pollow, 2006).
Another issue that might have caused the present problem is the weight of the baby. The induction was done and the baby was apparently quite big to enable it to pass through the cervix. This might have caused a rapture of the cervical walls hence causing the bleeding. The baby was 9 pounds that is 4.1 kgs which was quick big(Heilmann, et al, 2006).
One last thing that might have led to the primary problem was the epidural anesthesia. This anesthesia reduces the chances of the uterine muscles to contract. When the anesthesia was stopped, the muscles might have contracted suddenly. This might have led to another cause of the bleeding.
The abortion done 6 years ago does not have any impact on the patient’s current problem. This is evidenced by the previous pregnancies as they were not affected at all. If the abortion had any effect, the previous pregnancies would be affected as well. It is thus very evident that the abortion doesn’t have any effect on the current pregnancy state.
There are several approaches that can be used to positively impact a patient’s outcome. One on these approaches is simulation. Simulation is a very well-known term in the fields of military, aviation and nuclear power. Several land mark studies recommend this approach as a learning and teaching strategy. This has been integrated into the system of the physicians and nurses so as to better their development skills.
Simulation is basically a procedure not a technology and is used to perfect the real life processes with the guided processes. There is no common method used in the simulation processes though all the simulation processes normally follow the same procedure. There is normally a preparation learning which is undertaken by the participants before the simulation is undertaken. Implementation of the simulation is then done and later on debriefing is undertaken. Debriefing is normally done to review the participant’s performances and the person facilitating the process goes ahead to give a feedback(Aebersold & Tschannen, 2013).
Simulations has two advantages on reproductive health. These include:
- Simulation helps to provide the opportunity for the health workers to gain exposures to the scenarios that occur rarely or only during emergencies. This is beneficial in that it equips them with practical experience to handle these situations once they occur as it would be hard to get such a situation in the real life.
- This is normally a procedure that is undertaken as a team not as an individual, it thus gives one an opportunity to network and perfect on their communication skills and also creates team work in undertaking the procedure. This enables the participants to also gain the surgical experience and also perfect on their acquired skills by learning more from each other (Cant,& Cooper, 2010).
This approach however has some disadvantages, these include:
- One of the biggest disadvantages of simulation is that no matter how realistic they may seem to be, the mannequins that are used are still not real. They can and will never stand in the place of humans. The environment definitely chances when it comes to a human body which is to be worked on and definitely may create stress which will in turn affect the performance (Aebersold & Tschannen, 2013).
- Another challenge may be poor training to the educators mostly due to lack of access to the simulator and also expensive equipment that need to be used.
Perinatal cases are often very critical and hence the use of simulation in the training of the participants van help in gaining more experience. For example, Obstetrics is a specialty area where the nurses work in a very high risk and dynamic environment for 24 hours a day. This are basically focuses on the prevention of risk and also patient safety. (Cant, & Cooper, 2010).High training using the simulation approach can help a great deal in improving the perinatal process,