Obstetrics Emergency Department Simulation Training Program

OB ED Simulation Training Program

Rural ERs are becoming more and more important in the fight to reduce maternal morbidity and mortality and improve infant outcomes in the state of Iowa, and they are not always prepared for women seeking maternity services to walk into their facility. As part of the Statewide Obstetrics Mobile Simulation Training Program, one of our goals is to help educate ER providers on how to handle situations that may arise. These monthly, one-hour calls cover virtual didactic training on a number of situations that ER facilities and EMS providers may face with an OB patient. The long-term plan for this initiative includes monthly calls, on-demand access to recordings of previous sessions, virtual team sessions, and access to the OB Simulation Team as a resource for best practices in running your own simulations. In the future, we will be bringing training directly to your facility, as this is where you learn best and where your own internal QI processes will be made.

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GOAL

Improve counseling and use of patient education materials on warning signs and when to seek care. Increase patient awareness of signs and symptoms of common complications.

METHODS

Standardize patient education to ensure healthcare providers relay consistent messages. Nurses at all of Iowa’s 56 birthing hospitals and 23 Title V MCH agencies will be trained by AWHONN.

INTENDED RESULTS

Patients, families, and communities will have increased knowledge of warning signs or the need to seek care and be empowered to call for help. Patients will access care without delay when postpartum complications occur.

Amanda Staab, MSN, RNC-OB

Amanda completed her master’s degree through the Clinical Nurse Leader program at the University of Iowa in 2010. She has been at UnityPoint Health-St. Luke’s Hospital for the past 13 years. She has done a variety of roles in the Birth Care Center, including labor and delivery, postpartum, scrub/assist, anesthesia RN, charge, and OB educator. During COVID, she took on the challenge of the House Supervisor role. She has served on numerous unit-based, hospital-wide, and system-wide committees, simulation teams, and statewide initiatives. She serves as the AWHONN Chapter Leader for East Central Iowa and coordinates the vendors for the Iowa AWHONN Conference. She was chosen for AWHONN’s Emerging Leaders Program for 2023-2024. She currently works for the University of Iowa, under an HRSA grant, as a Clinical Nurse Improvement Coach for the Alliance for Innovation on Maternal Health (AIM) program.

Amanda Staab

Kokila Thenuwara, MD, MBBS, MME, MHCDS

Kokila is a Clinical Professor of Obstetrics Anesthesia at the University of Iowa Hospitals and Clinics. Thenuwara obtained her medical education in Sri Lanka. She completed her internship in internal medicine and her residency in anesthesiology at the University of Iowa. She obtained her master’s in medical education at the University of Iowa and her master’s in health care delivery science from Dartmouth College.

She is the Director of the New Faculty Development Program and Chair of the Best Practices Committee at the Department of Anesthesia at the University of Iowa. She is the Chair of the Simulation-Based Education subcommittee, supported by a Health Resources and Services Administration grant.

She is a written and applied examiner for the American Board of Anesthesiology, specializing in ethics and diversity, equity, and inclusion.

Kristal Graves, DNP, MSN, RN

Kristal received her ADN from Hawkeye Community College in 2000. She continued her education to obtain her master’s degree in nursing education, and in 2020 obtained her Doctor of Nursing Practice from Allen College.

She has worked in a critical access hospital for 19 years as a labor and delivery nurse. She also taught clinical, classroom, simulation, and lab for 12 years in the areas of obstetrics and pediatrics at the LPN, ADN, and BSN levels. She has been active in the areas of education and quality improvement within her career. She currently works for the University of Iowa, under the HRSA Maternal Health Innovation grant, as a Clinical Nurse Improvement Coach for the Alliance for Innovation on Maternal Health (AIM) program. Kristal is passionate about bringing quality improvement initiatives and education to Iowa’s obstetrical units. She has completed the IHI’s Improvement Coaching Program and is currently participating in the Breakthrough Series Collaborative professional development program.

Kristal Graves

Jill Henkle, RNC-OB

Jill has over 25 years of experience as a Critical Access Level 1 obstetrical nurse. She has also worked in the emergency department, medical surgical floor, telemetry, ICU, and as a travel nurse. As an OB Manager for over 10 years, Jill was successful with the implementation of maternal safety bundles, unity interdisciplinary simulation drills, process improvements, and evidence-based staff education; she still works at the bedside on a PRN basis.

Jill is an NRP Instructor, holds certification in Inpatient OB, is an AWHONN Intermediate EFM Instructor, and serves as the Iowa AWHONN Southwest Iowa Chapter Coordinator. Jill has worked with the Maternal Health Innovation grant funded by a Health Resources and Services Administration grant as an Improvement Coach through the Iowa Statewide Perinatal Care Program/AIM and is currently a member of the Iowa Mobile Statewide Simulation Team. Jill is a voice and advocate for rural maternity hospitals.

Jeana Forman, MSN, RNC-OB, C-EFM, C-FMC

Jeana is a Nursing Practice Leader at the University of Iowa Hospitals and Clinics. She has been a nurse at UIHC for over 20 years. Her career began as a staff nurse in the Inpatient OB units. She quickly found a love for staff education and has been in the area of staff education and development for the last 17 years. She is an Instructor for AWHONN Fetal Monitoring Programs, Neonatal Resuscitation, Advanced Cardiac Life Support, Advanced Life Support OB, and STABLE. She has found out firsthand how adding simulation to staff training and development improves the participant’s experience and engagement. Jeana is currently a member of the Iowa Statewide Mobile Simulation Team, which is supported by a Health Resources and Services Administration grant.

Jeana Forman

Steph Trusty, BSN, RN

Improvement Coach

Steph received her diploma in nursing from the Iowa Methodist School of Nursing and a Bachelor of Science degree in Nursing from Grand View University in Des Moines. She has worked in the obstetrical nursing field for over 40 years. Most of those years were spent working as a labor and delivery nurse and clinical educator for UnityPoint Methodist Hospital in Des Moines. For the past 15 years, she has provided leadership to the Title V Maternal Health program and Maternal Mortality Review Committee at the Iowa Department of Public Health, now Iowa Health and Human Services. She led efforts to implement the program statewide, the Period of PURPLE Crying, to prevent shaken baby syndrome. She was the team lead for the Iowa Infant Mortality CoIIN. She serves as the primary data abstractor for the Iowa Maternal Mortality Review Committee. She has provided consultation services to the Iowa Healthcare Collaborative and Iowa Medicaid on improving the quality and safety of obstetrical care in Iowa. Currently, Ms. Trusty is the AIM State Lead Coordinator. She also leads two subcommittees for the Iowa Statewide Perinatal Care Program: the statewide implementation of AWHONN’s POST-BIRTH Warning Signs and the social media campaign to encourage pregnant and postpartum women to wear a seatbelt. She has completed the IHI’s Improvement Coaching and Breakthrough Series Collaborative professional development programs.

Amanda Staab, MSN, RNC-OB

Improvement Coach

Amanda completed her master’s degree through the Clinical Nurse Leader program at the University of Iowa in 2010. She has been at UnityPoint Health-St. Luke’s Hospital for the past 13 years. She has done a variety of roles in the Birth Care Center, including labor and delivery, postpartum, scrub/assist, anesthesia RN, charge, and OB educator. During COVID, she took on the challenge of the House Supervisor role. She has served on numerous unit-based, hospital-wide, and system-wide committees, simulation teams, and statewide initiatives. She serves as the AWHONN Chapter Leader for East Central Iowa and coordinates the vendors for the Iowa AWHONN Conference. She was chosen for AWHONN’s Emerging Leaders Program for 2023-2024. She currently works for the University of Iowa, under an HRSA grant, as a Clinical Nurse Improvement Coach for the Alliance for Innovation on Maternal Health (AIM) program.

Amanda Staab

Stephanie Radke, MD, MPH, FACOG

Collaborative Director

Stephanie is a native Iowan and received her medical degree from the University of Iowa Carver College of Medicine. She then completed residency training in obstetrics and gynecology at the University of California Davis Medical Center and spent three years in community practice in Sacramento, CA. She returned to the University of Iowa to join the faculty in 2016 and is currently a Clinical Associate Professor. She is active in departmental quality improvement leadership and is a Co-Investigator on the HRSA State Maternal Health Innovation Program grant held by the Iowa Department of Health and Human Services. Through this work, she is leading efforts to form a Quality Collaborative for the state of Iowa with the goal of improving the quality, safety, and equity of maternity care in our state. She has completed the IHI’s Improvement Coaching and Breakthrough Series Collaborative professional development programs and will participate in the Improvement Advisory program in 2023.

Stephanie Radke

Kim Lake, MLS(ASCP)CM

Data Support

Kim has been involved in various aspects of healthcare for over 20 years. She is a certified Medical Laboratory Scientist who has had quality and management roles in pathology laboratories around Iowa City, most recently managing the Anatomic Pathology Laboratory at the University of Iowa Hospitals and Clinics. Throughout all her roles, she has maintained a passion for data and a firm belief in the power of data to drive informed decisions and lasting change.

Kim is currently working at the University of Iowa under the HRSA Maternal Health Innovation grant as an Epic Application Developer and Excel Wizard. Her multiple certifications in Epic applications make her an excellent resource for both general electronic medical record questions and Epic-specific information. Kim is also delighted to talk about reporting, data, and Excel with anyone and everyone.

Kristal Graves, DNP, MSN, RN

Improvement Coach

Kristal received her ADN from Hawkeye Community College in 2000. She continued her education to obtain her master’s degree in nursing education, and in 2020 obtained her Doctor of Nursing Practice from Allen College. She has worked in a critical access hospital for 19 years as a labor and delivery nurse. She also taught clinical, classroom, simulation, and lab for 12 years in the areas of obstetrics and pediatrics at the LPN, ADN, and BSN levels. She has been active in the areas of education and quality improvement within her career. She currently works for the University of Iowa, under the HRSA Maternal Health Innovation grant, as a Clinical Nurse Improvement Coach for the Alliance for Innovation on Maternal Health (AIM) program. Kristal is passionate about bringing quality improvement initiatives and education to Iowa’s obstetrical units. She has completed the IHI’s Improvement Coaching Program and is currently participating in the Breakthrough Series Collaborative professional development program.

Kristal Graves