scholarly journals P131 Transferring critically ill Covid-19 patients in ITU - A multidisciplinary training exercise

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Alex Tebbett ◽  
Ian Purcell ◽  
Shereen Watton ◽  
Rathinavel Shanmugham ◽  
Alexandra Tebbett
Keyword(s):  
Human Factors ◽  
Critically Ill ◽  
Situational Awareness ◽  
Training Session ◽  
Real Life ◽  
Team Leadership ◽  
Simulation Method ◽  
Task Management ◽  
In Situ Simulation ◽  
Staff Members

Abstract Introduction During Covid-19 many staff members were redeployed to the Intensive Care Unit (ICU) with little opportunity to train in the new skills they would require. One such skill was the transfer of a critically ill, and contagious, patient from ICU; a risky and complicated procedure which requires planning, preparation, risk assessment, situational awareness and, ideally, experience. To assist our colleagues in this skill an existing ICU transfer course has been adapted to cover the Covid-19 situation, or any similar contagious pandemic, in patient transfer. Methods An in-situ simulation method was chosen as the most realistic method of immersing our participants into the environment of ICU and to highlight real-life complexities and issues they may face. A multidisciplinary training session was devised so that novice anaesthetists, ACCPs and nurses could learn together, reflective of the usual team. Human factors such as communication, team leadership, task management and situational awareness are the focus of the post-simulation debrief, and human factors sheets have been created to guide the participants in analysing these skills. Pre- and post-simulation confidence, knowledge and attitudes will be assessed using validated appraisal tools and questionnaires to gather both quantitative and qualitative data about the experience. Discussion Multidisciplinary training is often difficult to arrange, due to the different requirements, processes, and procedures each department demands. A hidden blessing of Covid-19 is the realisation that this barrier can be broken, for the benefit of our patients and colleagues alike, and training sessions like this implemented.

125 INTRODUCING AN IN SITU SIMULATION PROGRAMME IN AN INTENSIVE CARE UNIT

2021 ◽  
Author(s):  
Harry Bateman ◽  
Karen Johnston ◽  
Andrew Badacsonyi ◽  
Natalie Clarke ◽  
Kathleen Conneally ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Human Factors ◽  
Professional Training ◽  
In Situ Simulation ◽  
Airline Pilots ◽  
Staff Members ◽  
Emergency Scenarios ◽  
The Impact

This North London hospital has a 14-bed Intensive Care Unit (ICU). As a small District General ICU, staff exposure to emergency scenarios can be infrequent. Lack of practice can lead to a reduction in staff confidence and knowledge when these scenarios are encountered, especially during the COVID pandemic. The ICU had not previously undertaken in situ multi-disciplinary team (MDT) simulation sessions on the unit.The aim of the study was to introduce a novel programme of MDT simulation sessions in the ICU and provide feedback with the aim of increasing both staff confidence in managing emergency scenarios and staff understanding of the impact of human factors.A team of ICU Simulation Champions created emergency scenarios that could occur in the ICU. Pre-simulation and post-simulation questionnaires were produced to capture staff opinion on topics including benefits and barriers to simulation training and confidence in managing ICU emergencies. Members of the ICU MDT would be selected to participate in simulation scenarios. Afterwards, debrief sessions would be facilitated by Simulation Champions and Airline Pilots with a particular focus on competence in managing the emergency and human factors elements, such as communication and leadership. Participants would then be surveyed with the post-simulation questionnaire.Nine simulation sessions were conducted between October 2020 and June 2021. The sessions occurred within the ICU during the working day in a designated bay with the availability of all standard ICU resources and involved multiple MDT members to aid fidelity. Feedback by Simulation Champions mainly focussed on knowledge related to the ICU emergency, whilst the Airline Pilots provided expert feedback on human factors training. Fifty-five staff members completed the pre-simulation questionnaire and 37 simulation participants completed the post-simulation questionnaire. Prior to simulation participation, 28.3% of respondents agreed they felt confident managing emergency scenarios on ICU – this figure increased to 54.1% following simulation participation. 94.4% of simulation participants agreed that their knowledge of human factors had improved following the simulation and 100% of participants wanted further simulation teaching. Figure 1 shows a thematic analysis of the responses from 31 participants who were questioned about perceived benefits from simulation teaching. Following the success of the programme, the Hospital Trust will continue to support and develop inter-speciality and inter-professional training, and have funded the appointment of an ICU Simulation Fellow to continue to lead and enhance future in situ simulation teaching on the ICU.

Team leadership and its personal background in the studengroup

2020 ◽  
Vol 1 (100) ◽  
pp. 42-49
Author(s):  
A.M. Pysarenko ◽  
Keyword(s):  
Team Leadership ◽  
Leadership Team ◽  
Specific Situation ◽  
Task Management ◽  
Leadership Qualities ◽  
Organizational Skills ◽  
Self Development ◽  
Management Functions ◽  
Psychological Features ◽  
Difficult Situations

The article anylyses the theoretical and methodological basis for the study of the problem of team leadership in the student environment: the importance of team formation in the student environment, the essence of the concept of "leadership", the psychological components of effective team leadership. Team leadership is seen as the ability of a leader to gain authority in one’s group, thereby gaining the primary right to make group decisions, as well as to recognize the strengths of others and delegate task management functions to others. Also, command leadership is seen as a process of allocating authoritative personalities in a group and facilitating them to develop leadership qualities of other members of the group, which leads to the emergence of coordinated teamwork. It is noted that tactics of the leader’s influence on the group can determine the effectiveness of team leadership. His typical actions, internal psychological features, ability to update the desired features in a specific situation. The authors consider the internal psychological features of students, which determine the command style of leadership, as follows: flexibility, originality, critical thinking, orientation to solving problems in difficult situations; desire for cooperation, diplomacy, ability to manage and resolve conflicts, organizational skills, communication skills; striving for self-development and self-improvement. The essence of the empirical study of the psychological components of effective team leadership in a student environment is highlighted.

A Lesson on Human Factors in Airway Management Learnt From the Death of George Washington

2020 ◽  
Vol 163 (5) ◽  
pp. 1000-1002
Author(s):  
Ahmad K. Abou-Foul
Keyword(s):  
Human Factors ◽  
Airway Management ◽  
Situational Awareness ◽  
Resistance To Change ◽  
Change Leadership ◽  
Acute Epiglottitis ◽  
George Washington ◽  
Leadership Model ◽  
Factors Analysis ◽  
Human Factors Analysis

On December 14, 1799, 3 prominent physicians—Craik, Brown, and Dick—gathered to examine America’s first president, George Washington. He was complaining of severe throat symptoms and was being treated with bloodletting, blistering, and enemas. Dick advised performing an immediate tracheotomy to secure the airway. Both Craik and Brown were not keen on trying tracheotomy and overruled that proposal. Washington was not involved in making that decision. He most likely had acute epiglottitis that proved to be fatal at the end. If Dick had prevailed, a tracheotomy could have saved Washington’s life. Human factors analysis of these events shows that his physicians were totally fixated on repeating futile treatments and could not comprehend the need for a radical alternative, like tracheotomy. That was aggravated by an impaired situational awareness and significant resistance to change. Leadership model was also based on hierarchy instead of competency, which might have also contributed to Washington’s death.

scholarly journals 764 Human Factors in Operative Theatres During the Covid-19 Pandemic: A Cross-sectional Analysis of Operating Theatre Staff Experiences in a Regional Centre

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
L E Murchison ◽  
R Anbarasan ◽  
A Mathur ◽  
M Kulkarni
Keyword(s):  
Human Factors ◽  
Online Survey ◽  
Situational Awareness ◽  
Negative Impact ◽  
High Stress ◽  
Operating Theatre ◽  
Free Text ◽  
Cross Sectional ◽  
Chi Squared ◽  
Theatre Staff

Abstract Introduction In the already high-risk, high-stress environment of the operating theatre, operating during Covid-19 has brought its own unique challenges. Communication, teamwork and anxiety related new operating practices secondary to Covid-19 are hypothesised to have a negative impact on patient care. Method We conducted a single-centre online survey of operating theatre staff from 22nd June–6th July 2020. Respondents completed 18 human factors questions related to COVID-19 precautions including communication, teamwork, situational awareness, decision making, stress, fatigue, work environment and organisational culture. Questions consisted of yes/no responses, multiple choice and Likert items. Kruskall-Wallis tests, Chi-Squared, Mann Whitney U tests, Spearman’s correlation coefficient, lambda and Cramer’s V tests were used. Free-text responses were also reviewed. Results 116 theatre staff responded. Visual (90.5%), hearing/ understanding (96.6%) difficulties, feeling faint/lightheaded (66.4%) and stress (47.8%) were reported. Decreased situational awareness was reported by 71.5% and correlated with visors (r = 0.27 and p = 0.03) and FFP2/3 mask usage (r = 0.29 and p = 0.01). Reduced efficiency of theatre teams was reported by 75% of respondents and 21.5% felt patient safety was at greater risk due to Covid-19 precautions in theatre. Conclusions Organisational adjustments are required, and research focused on development of fit-for-purpose personal protective equipment (PPE).

Development and Evaluation of Enhanced Airfield Signage for Temporary Information

2017 ◽  
Vol 2626 (1) ◽  
pp. 66-73
Author(s):  
Gaël Le Bris
Keyword(s):  
Human Factors ◽  
Situational Awareness ◽  
Weak Link ◽  
Advisory Council ◽  
Parallel Study ◽  
Research Projects ◽  
Charles De Gaulle ◽  
Definition Of ◽  
De Gaulle ◽  
Construction Works

The aviation community has faced several accidents and incidents on infrastructures and procedures temporarily modified for the purpose of construction works. The analysis of these events shows that usual means of communication to the air crews are the weak link of the safety chain. To address the key challenge of situational awareness during construction works, the Airport Construction Advisory Council of FAA and Paris–Charles de Gaulle Airport (Paris-CDG) developed and evaluated with the airfield community, from 2011 to 2016, an innovative aviation signage. Parallel and complementary studies in human factors led to the definition of specifications for a temporary information signage, also called orange construction sign. Paris-CDG focused on the development of specific messages for each one of the major hazards that could require an increased situational awareness of the air crews during taxiing and takeoff. The results of the evaluation conducted by FAA were published in September 2015. The purpose of this paper is to present the parallel study performed by the author at Paris-CDG with the coalition of the airside operations stakeholders. Both research projects are convergent and confirm the relevance of the orange sign concept for increasing the situational awareness and preventing safety events during airfield construction.

Fire in operating theatres: DaSH-ing to the rescue

2018 ◽  
Vol 28 (7-8) ◽  
pp. 188-193
Author(s):  
Liam Wilson ◽  
Omer Farooq
Keyword(s):  
Patient Care ◽  
Fire Safety ◽  
Training Session ◽  
Operating Theatre ◽  
In Situ Simulation ◽  
Safe Patient Care ◽  
Team Interactions ◽  
Operating Theatres ◽  
Theatre Staff ◽  
Safety Officer

Operating theatres are dynamic environments that require multi professional team interactions. Effective team working is essential for efficient delivery of safe patient care. A fire in the operating theatre is a rare but potentially life threatening event for both patients and staff. A rapid and cohesive response from theatre and allied staff including porters, fire safety officer etc is paramount. We delivered a training session that utilised in situ simulation (simulation in workplace). After conducting needs analysis, learning objectives were agreed. After thorough planning, the date and location of the training session were identified. Contingency plans were put in place to ensure that patient care was not compromised at any point. To ensure success, checklists for faculty were devised and adhered to. A medium fidelity manikin with live monitoring was used. The first part of the scenario involved management of a surgical emergency by theatre staff. The second part involved management of a fire in the operating theatre while an emergency procedure was being undertaken. To achieve maximum learning potential, debriefing was provided immediately after each part of the scenario. A fire safety officer was present as a content expert. Latent errors (hidden errors in the workplace, staff knowledge etc) were identified. Malfunctioning of theatre floor windows and staff unawareness about the location of an evacuation site were some of the identified latent errors. Thorough feedback to address these issues was provided to the participants on the day. A detailed report of the training session was given to the relevant departments. This resulted in the equipment faults being rectified. The training session was a very positive experience and helped not only in improving participants’ knowledge, behaviour and confidence but also it made system and environment better equipped.

scholarly journals Home-based Cardiac Rehabilitation - the real barriers of programs at distance

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
J Brito ◽  
I Aguiar-Ricardo ◽  
P Alves Da Silva ◽  
B Valente Da Silva ◽  
N Cunha ◽  
...  
Keyword(s):  
Exercise Training ◽  
Cardiac Rehabilitation ◽  
Real Time ◽  
Training Session ◽  
Real Life ◽  
Participation Rate ◽  
Exercise Session ◽  
Exterior Space ◽  
Supervised Exercise ◽  
Home Based

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Despite the established benefits of cardiac rehabilitation (CR), it remains significantly underutilized. Home-based CR (CR-HB) programs should offer the same core CR components as Centre-based programs (CR-CB) but several aspects need to be adapted, communication and supervision must be improved. Although CR-HB has been successfully deployed and is a valuable alternative to CR-CB, there is less structured experience with these non-uniform programs and further studies are needed to understand which patients (pts) are indicated to this type of program. Purpose To investigate pt-perceived facilitators and barriers to home-based rehabilitation exercise. Methods Prospective cohort study which included pts who were participating in a CR-CB program and accepted to participate in a CR-HB program after CR-CB closure due to COVID-19. The CR-HB consisted in a multidisciplinary digital CR program, including pt risk evaluation and regular assessment, exercise, educational and psychological sessions. The online exercise training sessions consisted of recorded videos and real time online supervised exercise training group sessions. It was recommended to do each session 3 times per week, during 60 min. A pictorial exercise training guidebook was available to all participants including instructions regarding safety, clothing and warm-up, and a detailed illustrated description of each  exercise sessions. Also, for questions or difficulties regarding the exercises, an e-mail and telephone was provided. Once a month, real time CR exercise sessions was provided with a duration of 60min. Results 116 cardiovascular disease pts (62.6 ± 8.9years, 95 males) who were attending a face-to-face CR program were included in a CR-HB program. The majority of the pts had coronary artery disease (89%) and 5% valvular disease. Regarding risk factors, obesity was the most common (75%) followed by hypertension (60%), family history (42%), dyslipidaemia (38%), diabetes (18%), and smoking (13%). Almost half (47%) of the participants did at least one online exercise training session per week: 58% did 2-3 times per week, 27% once per week and 15% more than 4 times per week. Participants who did less than one exercise session per week reported as cause: lack of motivation (38%), preference of a different mode of exercise training such as exercise in the exterior space (26%), technology barrier such as impossibility to stream online videos (11%), fear of performing exercise without supervision (4%), and limited space at home (4%). Conclusions Our study based on real-life results of a CR-HB program shows a sub-optimal rate of participation in exercise sessions due to different causes, but mainly for the lack of motivation to exercise alone or preference for walking in exterior space. The knowledge of the CR-HB program barriers will facilitate to find out strategies to increase the participation rate and to select the best candidates for this type of programs.

172 Scenario-based Training Is an Effective Tactic for Teaching Applied Livestock Management Practices to Extension Personnel

2021 ◽  
Vol 99 (Supplement_3) ◽  
pp. 92-92
Author(s):  
Jennie L Ivey ◽  
Lew G Strickland ◽  
Justin D Rhinehart
Keyword(s):  
Management Practices ◽  
Teaching Effectiveness ◽  
Training Session ◽  
Real Life ◽  
Extension Agents ◽  
Adult Educator ◽  
Topic Area ◽  
Virtual Training ◽  
Training Tool ◽  
Instructor Effectiveness

Abstract Developing livestock and equine trainings to empower county Extension agents is challenging, especially when spanning in-person and online delivery modules. Real life application of training concepts is difficult, particularly when participants have varied backgrounds and experience. Thus, we assessed if scenario-based training modules were an effective training method across in-person and virtual formats. The same scenario-based training was delivered at three, regional in-person trainings (n = 42), and one virtual training (n = 32). Training format consisted of four, species-specific lectures addressing various production topics. Small groups then developed recommendations for a specific scenario, followed by a debriefing session consisting of group reactions and specialist recommendations. Topic-area application to county programs, instructor effectiveness, and overall benefit of the training session were evaluated (Qualtrics, in-person n = 26, 62% completion; virtual n = 17, 53% completion). Data were assessed using analysis of variance and mean comparisons (α=0.05), with Tukey’s pairwise post hoc analysis where appropriate (STATA 16). Across all sessions, likert scale responses (1=poor and 5=excellent, n = 43) indicated lecture sessions were applicable to county areas of need across material content (mean±SD, cattle=4.71±0.57, equine=4.64±0.50), teaching effectiveness (cattle=4.77±0.42, equine=4.75±0.43), and overall quality (cattle=4.68±0.57, equine=4.67±0.51), respectively. Scenario-based training benefit was not influenced by the number of times an agent had attended in-service training on livestock species, agent appointment (youth vs. adult educator), or training location (p >0.05). Attendance at previous in-service trainings (cattle P = 0.005; equine P = 0.013) and agent appointment (cattle P = 0.0006; equine P = 0.05) had a significant impact on the number of questions agents reported to have received on scenario topics in the last 12 months. More topic area questions were reported by agents with adult education responsibilities and previous training attendance. Based upon these results, scenario-based training is an effective in-person and virtual training tool for 4-H and adult Extension agents of varying experience.

scholarly journals Using in situ simulation to improve care of the acutely ill patient by enhancing interprofessional working: a qualitative proof of concept study in primary care in England

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e028572
Author(s):  
Amy Halls ◽  
Mohan Kanagasundaram ◽  
Margaret Lau-Walker ◽  
Hilary Diack ◽  
Simon Bettles
Keyword(s):  
Primary Care ◽  
Training Session ◽  
Medical Emergency ◽  
Future Research ◽  
Proof Of Concept ◽  
In Situ Simulation ◽  
Concept Study ◽  
Interprofessional Working ◽  
General Practices

ObjectiveAcutely unwell patients in the primary care setting are uncommon, but their successful management requires involvement from staff (clinical and non-clinical) working as a cohesive team. Despite the advantages of interprofessional education being well documented, there is little research evidence of this within primary care. Enhancing interprofessional working could ultimately improve care of the acutely ill patient. This proof of concept study aimed to develop an in situ simulation of a medical emergency to use within primary care, and assess its acceptability and utility through participants’ reported experiences.SettingThree research-active General Practices in south east England. Nine staff members per practice consented to participate, representing clinical and non-clinical professions.MethodsThe intervention of an in situ simulation scenario of a cardiac arrest was developed by the research team. For the evaluation, staff participated in individual qualitative semistructured interviews following the in situ simulation: these focused on their experiences of participating, with particular attention on interdisciplinary training and potential future developments of the in situ simulation.ResultsThe in situ simulation was appropriate for use within the participating General Practices. Qualitative thematic analysis of the interviews identified four themes: (1) apprehension and (un)willing participation, (2) reflection on the simulation design, (3) experiences of the scenario and (4) training.ConclusionsThis study suggests in situ simulation can be an acceptable approach for interdisciplinary team training within primary care, being well-received by practices and staff. This contributes to a fuller understanding of how in situ simulation can benefit both workforce and patients. Future research is needed to further refine the in situ simulation training session.

Caring for critically ill infants: strategies to promote physiological stability and improve developmental outcomes

1999 ◽  
Vol 19 (6) ◽  
pp. 64-79 ◽  
Author(s):  
LT Taquino ◽  
T Lockridge
Keyword(s):  
Supportive Care ◽  
Critically Ill ◽  
Care Setting ◽  
Well Being ◽  
Critical Care Nurses ◽  
Adverse Outcomes ◽  
Cognitive Growth ◽  
Staff Members ◽  
Improved Outcomes ◽  
Developmentally Supportive Care

Promoting organization and delivering developmentally supportive care leads to improved outcomes for infants and their families. Critical care nurses must function as catalysts to expand the thinking of caregivers from a dimension consisting primarily of physiology to one that embraces the emotional and cognitive growth and well-being of the patient, the patient's family, and staff members. For critically ill infants, developmentally supportive care that is relationship based and that promotes the balance of organized neurobehavioral and physiological function is an avenue to achieve that end. Beneficial or adverse outcomes of nursing care used during this critical period can persist long after an infant is discharged from the intensive care setting.

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