Simulation training for critical care

2016 ◽  
Author(s):  
Ben Shippey ◽  
Graham Nimmo
Keyword(s):  
Critical Care ◽  
Patient Safety ◽  
Patient Care ◽  
Simulation Training ◽  
Assessment Tool ◽  
Common Elements ◽  
Clinical Environment ◽  
Summative Assessments ◽  
Educational Efficiency ◽  
Educational Methodology

Simulation in various guises can be an extremely useful educational methodology. Its use should be planned carefully to maximize educational efficiency and minimize disruption to patient care. It requires the facilitator to enable the participants to behave as they would in the real clinical environment. Fidelity is one aspect of the simulated clinical environment that helps participants engage with the clinical material. The participants should be debriefed after the simulated experience. Video-assisted debriefing facilitates reflection on elements of behaviour that affect patient safety. Many styles of debriefing exist, but there are common elements. Debriefing should be carefully facilitated by faculty with the necessary skills. Simulation is increasingly being used as an assessment tool, but the validity of summative assessments using simulation is unclear.

What educational and other experiences assist recently qualified nurses to understand and deal with clinical risk and patient safety?

2021 ◽  
Author(s):  
◽  
Philip Charles Hawes
Keyword(s):  
Patient Safety ◽  
Clinical Practice ◽  
Learning Styles ◽  
Patient Care ◽  
Role Models ◽  
Clinical Environment ◽  
Contributing Factors ◽  
Clinical Role ◽  
Safe Patient Care ◽  
Clinical Risk

<p>This research was undertaken to investigate how newly graduated nurses recognise and develop skills relating to clinical risk and patient safety. I set out to understand how and where new graduates learn those skills and what would help future undergraduate nurses better prepare for the complexities of the clinical setting.  A qualitative research study using Appreciative Inquiry (AI) was the chosen methodology. This was selected for its aspirational outlook, which allows positive conclusions to be drawn from the study’s findings. Nine nurses in their first year of clinical practice participated in the study and they were interviewed on a one-to-one basis.  The key findings demonstrated that the approaches to teaching clinical risk and safe patient care and experiences of these in the undergraduate setting were variable, with many participants describing that they were ill prepared for the rigours of the clinical environment. They identified workplace culture, clinical role models, exposure to the clinical environment; experiential learning, narrative story sharing, debriefing and simulation as contributing factors to their ability to learn and understand clinical risk and safe patient care.  Despite their initial uncertainty, the participants were able to describe safe patient care and clinical risk. They identified cultures of safe patient care, safe teaching and safe learning. The participants further identified their preferred learning styles and recommended strategies that educationalists and clinical stakeholders employ to facilitate their professional development and understanding of clinical risk and patient safety.  The participants identified a more thoughtful, structured and overt approach to teaching the subject of clinical risk and patient safety to prepare for the clinical environment. They desired more experiential exposure, either clinical or simulated. They highlighted the need for effective preceptors and role models, alongside opportunities for sharing their clinical experiences and debriefing critical incidents. Furthermore, they recognised aspects of workplace cultures that facilitated or hindered effective clinical practice and safe patient care.</p>

scholarly journals The Effect of An Educational Program on Nurses’ Practices Regarding The Implementation of Patient Care and Safety Measures During Nasogastric Tube Feeding in The Critical Care Units in Syria

2021 ◽  
Vol 17 (29) ◽  
pp. 59
Author(s):  
Yaser Adnan Abo Jeesh ◽  
Elham Fath-Elalium Mohammed Khalid ◽  
Ishraqa Mohammed Ahmed Elbashier
Keyword(s):  
Critical Care ◽  
Patient Safety ◽  
Intensive Care ◽  
Quality Of Care ◽  
High Risk ◽  
Patient Care ◽  
Educational Program ◽  
Safety Measures ◽  
Before And After

The intensive care unit (ICU) is considered a high- risk area in the hospital because of the severity of injuries and the high liability of occurrences associated with ICU. Critically ill patients are at high risk for actual or potential life-threating health problems. Moreover, critical care nurses must develop their knowledge, skills, and safe practice in acute areas where patients require more detailed observation or intervention to deliver safe and effective care. Objectives: This study aimed to assess the effect of an educational program on nurses’ practices regarding the implementation of patient care and safety measures during enteral feeding. Design: The quasi-experimental design was used in this study. Methods: The study was conducted from June to September 2020. All registered nurses who were working in the intensive care units during the period of data collection comprised the sample. Based on the nurses’ needs regarding the condition of their competencies during the initial assessment, we developed and designed the educational program. This program consists of two parts: theory and practical. The program contains workshop (8 hours) per day and educational pamphlet handout. The workshop consists of PowerPoint presentations, group discussions, and training scenarios. Results: This study was carried out with 48 nurses working in the previous intensive care units. The nurses’ score were improved after the program regarding to nurses’ age, qualification, and experience. The overall study found a statistically significant relationship of this procedure before and after the implementation of the educational program (p<0.001). Conclusion: There has been remarkable and variation improvement of nurses performance after they received the education program. The results show that a statistically significant difference was found before and after implementing the program regarding the nurses’ age, qualification, and experience. It is recommended to pay more attention to these nurses by helping them to improve their knowledge and practices in all nursing interventions. Furthermore, it is necessary to improve nurses’ awareness regarding the quality of care and patient safety. It was also found that the poor knowledge and practice and its complications have a negative impact on the quality of care and patient safety. 

scholarly journals Use of Cognitive Simulation During Anesthesiology Resident Applicant Interviews to Assess Higher-Order Thinking

2016 ◽  
Vol 8 (3) ◽  
pp. 417-421 ◽  
Author(s):  
Alan W. Kulig ◽  
Rebecca D. Blanchard
Keyword(s):  
Patient Safety ◽  
Critical Thinking ◽  
Real Time ◽  
Simulation Training ◽  
Assessment Tool ◽  
Higher Order Thinking ◽  
Thinking Skills ◽  
Higher Order ◽  
Simulation Performance ◽  
Cognitive Simulation

ABSTRACT  It is difficult to assess applicants' higher-order cognitive thinking skills during conventional resident interviews. Application metrics currently employed are useful indicators of academic and personal success in targeted areas, yet value of this information in predicting future clinical performance is limited.Background  We developed an assessment tool to evaluate higher-order cognitive function in real time during anesthesiology resident applicant interviews.Objective  During the 2014–2015 residency interview season, we integrated simulation training into applicant interviews to evaluate higher-order cognitive skills. Our 5-minute simulation emphasized the Team STEPPS 2-Challenge Rule and explored candidates' critical thinking, analytical decision making, and response to stress. Participating applicants were evaluated using an outcomes-based checklist targeting desired responses. We also sent applicants a post-National Resident Matching Program survey to assess their perceptions of the simulation's value and educational utility.Methods  A total of 90 applicants (75% of all applicants) participated in the simulation, which taught residents about important patient safety concepts and provided the program with real time information about their critical thinking ability. All applicants were confident or very confident that they would both speak up and know what to say if they encountered a patient safety breach as a result of participating in this exercise. Simulation performance affected desirability status for 35% of participating applicants, where 23% of applicants ranked higher, and 12% ranked lower compared to baseline application status.Results  Cognitive simulation training was useful in assessing resident applicant higher-order thinking skills and in helping stratify candidates in conjunction with standard application metrics.Conclusions

scholarly journals What educational and other experiences assist recently qualified nurses to understand and deal with clinical risk and patient safety?

2021 ◽  
Author(s):  
◽  
Philip Charles Hawes
Keyword(s):  
Patient Safety ◽  
Clinical Practice ◽  
Learning Styles ◽  
Patient Care ◽  
Role Models ◽  
Clinical Environment ◽  
Contributing Factors ◽  
Clinical Role ◽  
Safe Patient Care ◽  
Clinical Risk

<p>This research was undertaken to investigate how newly graduated nurses recognise and develop skills relating to clinical risk and patient safety. I set out to understand how and where new graduates learn those skills and what would help future undergraduate nurses better prepare for the complexities of the clinical setting.  A qualitative research study using Appreciative Inquiry (AI) was the chosen methodology. This was selected for its aspirational outlook, which allows positive conclusions to be drawn from the study’s findings. Nine nurses in their first year of clinical practice participated in the study and they were interviewed on a one-to-one basis.  The key findings demonstrated that the approaches to teaching clinical risk and safe patient care and experiences of these in the undergraduate setting were variable, with many participants describing that they were ill prepared for the rigours of the clinical environment. They identified workplace culture, clinical role models, exposure to the clinical environment; experiential learning, narrative story sharing, debriefing and simulation as contributing factors to their ability to learn and understand clinical risk and safe patient care.  Despite their initial uncertainty, the participants were able to describe safe patient care and clinical risk. They identified cultures of safe patient care, safe teaching and safe learning. The participants further identified their preferred learning styles and recommended strategies that educationalists and clinical stakeholders employ to facilitate their professional development and understanding of clinical risk and patient safety.  The participants identified a more thoughtful, structured and overt approach to teaching the subject of clinical risk and patient safety to prepare for the clinical environment. They desired more experiential exposure, either clinical or simulated. They highlighted the need for effective preceptors and role models, alongside opportunities for sharing their clinical experiences and debriefing critical incidents. Furthermore, they recognised aspects of workplace cultures that facilitated or hindered effective clinical practice and safe patient care.</p>

scholarly journals Reducing sitter use in acute medicine while maintaining safety and quality

2018 ◽  
Vol 9 (2) ◽  
pp. 61
Author(s):  
Delois Long ◽  
Janice Dennis
Keyword(s):  
Patient Safety ◽  
Patient Care ◽  
Assessment Tool ◽  
Medical Center ◽  
Intervention Group ◽  
Post Intervention ◽  
Acute Medicine ◽  
Quality Of Patient Care ◽  
Interventional Group

Background and objective: Sitters are commonplace in acute care facilities throughout the country. Sitters are used to provide close observations and ensure safety for patients who are at risk for falls. These patients suffer from cognitive impairment, inability to follow instructions, and causing harm to themselves or others. The literature shows that one requirement for an effective sitter process is the use of an assessment tool. Sitter usage at the Louis Stokes Cleveland VA Medical Center (LSCVAMC) has escalated to the point that sitters are causing an overall shortage of nursing staff.  This shortage causes excessive overtime, staff burnout, and reduces the quality of patient care provided to non-sitter patients. The purpose of this case-control descriptive pilot study was to reduce sitter usage on an inpatient acute medicine unit, by implementing the Patient Attendant Assessment Tool (PAAT), without reducing patient safety and quality of patient care. The PAAT was developed and utilized by a Midwest hospital for data collection and to assess the need for sitters.Methods: Patients were placed into the Pre- and Post-implementation cohorts, according to the order of their admission. Pre-interventional data was collected from the study group, using the Sitter Justification Form, the 24-hour nursing report and the electronic medical record. The intervention consisted of staff education on the use of a new tool, the PAAT. Following implementation of the tool, the data was collected and analyzed using the SPSS 20 for windows (SPSS.INC), over an 8-month period.Results and conclusions: Sitter usage was reduced without reducing patient safety or quality of care, with the implementation of the PAAT. Among individuals having at least one sitter day, patients in the post intervention group, were less likely to have as many sitter shifts (n = 343, 58.0%) as compared to patients in the Pre-interventional group (n = 451, 75.9%) (Chi Square = 42.88; df = 1, p < .001). As can be seen, there was a significant decrease in the number of sitter shifts after the implementation of the PAAT, as compared to the pre-interventional group. There was a slight increase in the quality of patient care.

scholarly journals Rapid Cycle Deliberate Practice to Facilitate “Nano” In Situ Simulation: An Interprofessional Approach to Just-in-Time Training

2021 ◽  
Vol 41 (1) ◽  
pp. e1-e8
Author(s):  
Kristen M. Brown ◽  
Shawna S. Mudd ◽  
Julianne S. Perretta ◽  
Adam Dodson ◽  
Elizabeth A. Hunt ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Patient Safety ◽  
Intensive Care ◽  
Simulation Training ◽  
Deliberate Practice ◽  
Care Providers ◽  
In Situ Simulation ◽  
Practice Method

Background Simulation is increasingly used to identify latent threats to patient safety, such as delays in recognition and management of time-sensitive conditions. The Rapid Cycle Deliberate Practice teaching method may facilitate “nano” (brief) in situ simulation training in a critical care setting to improve multidisciplinary team performance of time-sensitive clinical tasks. Objective To determine whether nano–in situ simulation training with Rapid Cycle Deliberate Practice can improve pediatric intensive care unit team proficiency in identifying and managing postoperative shock in a pediatric cardiac patient. Methods A quality improvement educational project was conducted involving nano–in situ simulation sessions in a combined pediatric and pediatric cardiac intensive care unit. The Rapid Cycle Deliberate Practice method was used with an expert-driven checklist for 30-minute simulation scenarios. Results A total of 23 critical care providers participated. The proportion of time-sensitive tasks completed within 5 minutes increased significantly from before to after training (52% [13 of 25] vs 100% [25 of 25]; P ≤ .001). Using a 5-point Likert scale, with higher scores indicating higher levels, the participants reported high degrees of performance confidence (mean, 4.42; SD, 0.20) and satisfaction with the simulation experience (mean, 4.96; SD, 0.12). Conclusion The Rapid Cycle Deliberate Practice method was used to facilitate nano–in situ simulation training and identify areas requiring additional education to improve patient safety. In situ simulation can educate providers in a cost-effective and timely manner.

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