ICU nurse advanced life support re-accreditation: the feasibility of a multidisciplinary team-based in-situ simulation approach

2017 ◽  
Vol 30 (2) ◽  
pp. 111
Author(s):  
Nerilee Baker ◽  
Susan Whittam ◽  
Sean Scott ◽  
Nilesh Mahale ◽  
Peter McCanny ◽  
...  
Keyword(s):  
Multidisciplinary Team ◽  
Life Support ◽  
Advanced Life Support ◽  
Simulation Approach ◽  
In Situ Simulation

scholarly journals Impact of In Situ Education on Management of Cardiac Arrest after Cardiac Surgery

2021 ◽  
Vol 23 (2) ◽  
pp. 54-61
Author(s):  
Bhargavi Gali ◽  
◽  
Grace Arteaga ◽  
Glen Au ◽  
Vitaly Herasevich
Keyword(s):  
Cardiac Arrest ◽  
Cardiac Surgery ◽  
Life Support ◽  
Advanced Life Support ◽  
Cardiac Massage ◽  
Chest Compressions ◽  
In Situ Simulation ◽  
Before And After ◽  
Initial Medication

Background: Advanced life support interventions have been modified for patients who have recently undergone sternotomy for cardiac surgery and have new suture lines. We aimed to determine whether the use of in-situ simulation increased adherence to the cardiac surgery unit-advanced life support algorithm (CSU-ALS) for patients with cardiac arrest after cardiac surgery (CAACS). Methods: This was a retrospective chart review of cardiac arrest management of patients who sustained CAACS before and after implementation of in-situ simulation scenarios utilizing CSU-ACLS in place of traditional advanced cardiac life support. We utilized classroom education of CSU-ACLS followed by in-situ high-fidelity simulated scenarios of patients with CAACS.. Interprofessional learners (n = 210) participated in 18 in-situ simulations of CAACS. Two groups of patients with CAACS were retrospectively compared before and after in situ training (preimplementation, n=22 vs postimplementation, n=38). Outcomes included adherence to CSU-ALS for resuscitation, delay in initiation of chest compressions, use of defibrillation and pacing before external cardiac massage, and time to initial medication. Results: Chest compressions were used less often in the postimplementation vs the preimplementation period (11/22 [29%] vs 13/38 [59%], P = 0.02). Time to initial medication administration, use of defibrillation and pacing, return to the operating room, and survival were similar between periods. Conclusion: In this pilot, adherence to a key component of the CSU-ALS algorithm—delaying initiation of chest compressions—improved

scholarly journals In-situ child and adolescent mental health simulation with human factors feedback delivered by airline pilots

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S136-S136
Author(s):  
Megan Fisher ◽  
Alexander Jolly ◽  
Mumtaz Mooncey ◽  
Kerry Robinson ◽  
Robert Lloyd ◽  
...  
Keyword(s):  
Mental Health ◽  
Human Factors ◽  
Positive Feedback ◽  
Multidisciplinary Team ◽  
Simulation Training ◽  
High Stress ◽  
Adolescent Mental Health ◽  
In Situ Simulation ◽  
Airline Pilots

AimsTo encourage multidisciplinary team learning by introducing Child & Adolescent Mental Health (CAMHS) in-situ simulation training.To provide focused Human Factors feedback through the expertise of senior airline pilots.MethodThe integration of the WingFactors in-situ simulation programme to multiple departments at Whittington Health NHS Trust has transformed the education landscape. The programme has received unanimously positive feedback, and the potential benefits for not only physical, but also mental health training, have been quickly recognised. A total of 90 simulations have been performed. A number of CAMHS scenarios have been designed with the primary aims of encouraging multidisciplinary training and increasing the focus on Human Factors in Psychiatry.Simulation scenarios were performed in real clinical environments with primed actors, thus enabling high-fidelity in-situ simulation. Immediate ‘hot’ debriefs were delivered by clinical faculty and uniformed airline pilots, with emphasis on psychological safety to encourage participation from all team members. The key learning points were then detailed in written documents and circulated to the wider team as a valuable learning resource.The first CAMHS simulation involved the acute management of a collapsed patient in the Emergency Department toilet, with a ligature tied around her neck and accompanied by a distressed patient. Another scenario addressed de-escalation techniques when dealing with a patient presenting with an overdose, who was threatening to leave the ward and posing potential risk to herself.ResultThe nature of these in-situ simulations enabled the multidisciplinary team to analyse practical considerations in the management of acute clinical situations. Scenarios were designed to focus on areas which had been identified as needing improvement for patient safety.The observations provided by airline pilots increased the focus on Human Factors training. A number of key themes were identified, including the importance of effective team-briefing, distraction management and task allocation. This is of particular significance when managing a distressed patient and anxious relative, in a busy high-stress clinical environment.ConclusionIn-situ simulation is a newly emerging concept in the field of Psychiatry, and the success of this programme has been highlighted through consistently positive feedback from participants, and nomination for the HSJ Award (Best Education Programme 2021). The involvement of airline pilots has promoted collaborative learning amongst the multidisciplinary team, and increased the focus on Human Factors in Psychiatry, clearly demonstrating the value of in-situ simulation training in this field.

P1856KIDNEY CRISES: USING IN SITU SIMULATION TEACHING TO FACILITATE MULTIDISCIPLINARY TEAM WORKING IN RENAL EMERGENCIES

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Ailish Nimmo ◽  
Katie Adams
Keyword(s):  
Life Support ◽  
Clinical Skills ◽  
Junior Doctors ◽  
Clinical Environment ◽  
Dialysis Unit ◽  
In Situ Simulation ◽  
Team Working ◽  
Clinical Scenarios ◽  
Medical Emergencies

Abstract Background and Aims The haemodialysis unit is a unique clinical environment. Specialist nursing staff look after patients, frequently without on-site medical cover, and need to manage medical issues until help arrives. Junior doctors often have limited experience managing renal patients and may not be aware of specialty-specific issues when dealing with medical emergencies. The different skill sets in these groups creates an opportunity for shared learning. Simulation teaching provides a safe environment for individuals to develop communication, team working and clinical skills and helps facilitate discussion and reflection on clinical scenarios. We describe a programme of renal in situ simulation sessions for nurses and junior doctors to allow them to practise their roles in an emergency and evaluate feedback on their perception of the programme. Method Seventeen hour-long simulation sessions were delivered between June 2017 and January 2020 within the renal ward in 2 hospitals and in a satellite outpatient dialysis unit. They utilised a high-fidelity SimMan® mannequin. Scenarios were based on common or rare-but-serious medical emergencies (hyperkalaemic cardiac arrest, arrhythmia on dialysis, air embolism, major haemorrhage post-renal biopsy, line sepsis, hypertensive seizure, pulmonary oedema and drug-induced anaphylaxis). Sessions comprised an orientation to the mannequin, a clinical scenario and a debrief discussion. Doctors and nurses completed post-tutorial feedback exploring their thoughts on the programme. Results 59 healthcare professionals (40 doctors and 19 nurses) participated and completed post-event feedback. All attendees felt that sessions improved their knowledge and increased their confidence in managing similar scenarios in the future. They all felt they would be able to apply their learning to their day job. 86% of participants strongly agreed that the programme helped them develop stronger relationships with colleagues. In white-space boxes, individuals described the sessions as being helpful in developing communication, teamwork, leadership and delegation skills in addition to specific learning points for the individual scenarios. Sessions also identified practical issues, such as where to source medications or monitoring equipment, and led to the creation of an updated protocol folder and distribution of Advanced Life Support algorithms throughout the ward. Conclusion Nurses and junior doctors report increased confidence in managing medical emergencies in renal patients and improved relationships with colleagues following a simulation training programme. The programme promotes a learning culture within the unit. It provides an opportunity to discuss potentially serious situations and allows reflection on similar scenarios encountered within the ward and dialysis unit. Further work is needed to determine if in situ simulation teaching has an impact on patient outcome measures.

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