scholarly journals Effect of Just-in-time Simulation Training on Tracheal Intubation Procedure Safety in the Pediatric Intensive Care Unit

2010 ◽  
Vol 113 (1) ◽  
pp. 214-223 ◽  
Author(s):  
Akira Nishisaki ◽  
Aaron J. Donoghue ◽  
Shawn Colborn ◽  
Christine Watson ◽  
Andrew Meyer ◽  
...  
Keyword(s):  
Intensive Care ◽  
Tracheal Intubation ◽  
Pediatric Intensive Care ◽  
Just In Time ◽  
Resident Participation ◽  
Intervention Phase ◽  
Refresher Training ◽  
Time Simulation ◽  
Simulation Based ◽  
Multidisciplinary Simulation

Background Tracheal intubation-associated events (TIAEs) are common (20%) and life threatening (4%) in pediatric intensive care units. Physician trainees are required to learn tracheal intubation during intensive care unit rotations. The authors hypothesized that "just-in-time" simulation-based intubation refresher training would improve resident participation, success, and decrease TIAEs. Methods For 14 months, one of two on-call residents, nurses, and respiratory therapists received 20-min multidisciplinary simulation-based tracheal intubation training and 10-min resident skill refresher training at the beginning of their on-call period in addition to routine residency education. The rate of first attempt and overall success between refresher-trained and concurrent non-refresher-trained residents (controls) during the intervention phase was compared. The incidence of TIAEs between preintervention and intervention phase was also compared. Results Four hundred one consecutive primary orotracheal intubations were evaluated: 220 preintervention and 181 intervention. During intervention phase, neither first-attempt success nor overall success rate differed between refresher-trained residents versus concurrent non-refresher-trained residents: 20 of 40 (50%) versus 15 of 24 (62.5%), P = 0.44 and 23 of 40 (57.5%) versus 18 of 24 (75.0%), P = 0.19, respectively. The resident's first attempt and overall success rate did not differ between preintervention and intervention phases. The incidence of TIAE during preintervention and intervention phases was similar: 22.0% preintervention versus 19.9% intervention, P = 0.62, whereas resident participation increased from 20.9% preintervention to 35.4% intervention, P = 0.002. Resident participation continued to be associated with TIAE even after adjusting for the phase and difficult airway condition: odds ratio 2.22 (95% CI 1.28-3.87, P = 0.005). Conclusions Brief just-in-time multidisciplinary simulation-based intubation refresher training did not improve the resident's first attempt or overall tracheal intubation success.

Abstract P38: Just-In-Time Simulation Training Improves ICU Physician Trainee Airway Resuscitation Participation without Compromising Procedural Success or Safety

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Akira Nishisaki ◽  
Shawn Colborn ◽  
Christine Watson ◽  
Dana Niles ◽  
Susan Ferry ◽  
...  
Keyword(s):  
Simulation Training ◽  
Orotracheal Intubation ◽  
Healthcare Research ◽  
Just In Time ◽  
Resident Participation ◽  
Exact Test ◽  
Time Simulation ◽  
Simulation Based ◽  
Physician Trainee ◽  
Procedural Success

Introduction : Competence in orotracheal intubation is a requirement for Pediatric residency. However, opportunities for residents are limited. We hypothesize Just-in-Time simulation-based multi-disciplinary team training for acute airway resuscitation in a pediatric ICU (PICU) would improve physician trainee intubation participation and success, and decrease undesired T racheal I ntubation A ssociated E vents ( TIAE ) such as esophageal intubation, or mainstem intubation. Methods : With IRB approval, on-call residents in a tertiary PICU received 30 minute airway resuscitation multidisciplinary simulation training before 24 hour on-call duties. Airway resuscitation performance was captured in both simulated and real airway resuscitations using a validated airway registry (NEAR-4-KIDS) tool. Resident participation, success, first attempt success, and the incidence of TIAE were compared before and after this intervention (Pre: Jan 2005–Jun11, 2007; Post: Jun12, 2007–May2008). Analysis by time series analysis, and Fisher’s exact test. Results : 150 simulation training sessions were conducted, and 123 consecutive real orotracheal intubations were evaluated. Resident participation significantly increased: Pre 23 % vs Post 36 % (p=0.016). Overall resident airway resuscitation success (58% vs. 68%, p=0.39) and first attempt success (44% vs. 56%, p= 0.30) improvement were not statistically significant. Despite the increased participation by resident trainees, there was no increase in TIAE (23% vs. 21%, p=0.78) in real airway resuscitation. Conclusion : Simulation-based “Just-in-Time” multidisciplinary training for pediatric advanced airway resuscitation improved actual resident trainee participation in real ICU intubations, but did not compromise airway resuscitation procedural success or patient safety. Supported by Agency for Healthcare Research and Quality (AHRQ), and CHOP Endowed Chair, Critical Care Medicine

Qualitative Evaluation of Just-in-Time Simulation-Based Learning

2013 ◽  
Vol 8 (1) ◽  
pp. 43-48 ◽  
Author(s):  
Gunjan Kamdar ◽  
David O. Kessler ◽  
Lindsey Tilt ◽  
Geetanjali Srivastava ◽  
Kajal Khanna ◽  
...  
Keyword(s):  
Qualitative Evaluation ◽  
Just In Time ◽  
Time Simulation ◽  
Simulation Based

ANALYSIS OF TRACHEAL INTUBATION ATTEMPTS AND FAILURES IN A PEDIATRIC INTENSIVE CARE UNIT.

2005 ◽  
Vol 33 ◽  
pp. A121
Author(s):  
Gim Tan ◽  
Lisa Tyler ◽  
Troy E Dominguez ◽  
Cheryl DeFalco ◽  
Vinay Nadkarni ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Tracheal Intubation ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care

scholarly journals Can Simulation Based-Team Training Impact Bedside Teamwork in a Pediatric Intensive Care Unit?

2019 ◽  
Vol 08 (04) ◽  
pp. 195-203
Author(s):  
Nora Colman ◽  
Janet Figueroa ◽  
Courtney McCracken ◽  
Kiran B. Hebbar
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Situational Awareness ◽  
Pediatric Intensive Care ◽  
Team Training ◽  
Safe Patient Care ◽  
Study Results ◽  
Simulation Based ◽  
Teamwork Skills

AbstractEffective teamwork performance is essential to the delivery of high-quality and safe patient care. In this mixed methodological observational cohort study, we evaluated team performance immediately following a real medical crisis in a pediatric intensive care unit (PICU) following implementation of a simulation-based team training (SBTT) program. Comparison of teamwork skills when rated by study observers demonstrated a statistically significant improvement in 12 out of 15 composite teamwork skills during real emergency events following SBTT (p < 0.05). Pre- and post-SBTT intervention survey data demonstrated an improvement in the perception of teamwork, most notable in the area of shared mental model and situational awareness following SBTT. Study results suggest that teamwork behaviors and skills acquired during SBTT can translate into improved bedside performance in the PICU.

scholarly journals Simulation-Based Team Training Improves Team Performance among Pediatric Intensive Care Unit Staff

2018 ◽  
Vol 08 (02) ◽  
pp. 083-091 ◽  
Author(s):  
Nora Colman ◽  
Janet Figueroa ◽  
Courtney McCracken ◽  
Kiran Hebbar
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Team Performance ◽  
Pediatric Intensive Care ◽  
Team Training ◽  
Subspecialty Training ◽  
Intensive Care Unit Staff ◽  
Simulation Based ◽  
The Impact

AbstractSimulation training fosters collaborative learning and improves communication among interdisciplinary teams. In this prospective observational cohort study, we evaluated the impact of interdisciplinary simulation-based team training (SBTT) on immediate learning of team performance behaviors. In a 3-month period, 30 simulation sessions were conducted and 165 staff members, including physicians, nurses, and respiratory therapists, were trained. Regression analysis showed a statistically significant improvement in team performance (p < 0.0001). Study results demonstrate that SBTT is effective in immediate acquisition of optimal team performance behaviors by multidisciplinary pediatric intensive care unit staff, including physicians with higher level subspecialty training in the simulation environment.

scholarly journals To Sedate or Not to Sedate? Lessons Learned from a Novel Pediatric Simulation-Based Training Curriculum for Procedural Sedation Privileges in Acute Care Pediatricians

2019 ◽  
Vol 34 (s1) ◽  
pp. s172-s172
Author(s):  
Paul Severin ◽  
Beverley Robin
Keyword(s):  
Intensive Care ◽  
Acute Care ◽  
Neonatal Intensive Care ◽  
Demographic Data ◽  
Pediatric Intensive Care ◽  
Lessons Learned ◽  
Procedural Sedation ◽  
Simulation Based ◽  
Simulation Center ◽  
Attending Physicians

Aim:To develop a simulation-based pediatric procedural sedation curriculum for acute care attending physicians to achieve and maintain privileges in this important skill.Methods:Neonatal and pediatric intensive care physicians participated in simulation-based sedation training to achieve and maintain sedation privileges. Participants were required to review pediatric sedation materials prior to participation. Demographic data were collected prior to the simulations, and all participants completed a pre-test to assess their baseline knowledge. Sessions were held in the simulation center or neonatal intensive care unit (depending on group), and the attending physicians, in pairs, participated in two high-fidelity mannequin scenarios (sedation for a painful procedure; hypoxia during sedation). Simulations were followed by a facilitated debriefing session while utilizing a standard performance checklist. All participants completed a program evaluation at the conclusion of their training.Results:Neonatal (n=11) and pediatric (n=9) intensive care attending physicians participated in the sedation simulation training. The program was well received and 100% rated it as “excellent” or “very good”. All participants strongly agreed the instructors allotted time for questions/answers, 100% strongly agreed the debriefing/feedback was effective, 95% strongly agreed instructors had a thorough knowledge and understanding of the program, were supportive, and facilitated learning, and 95% strongly agreed the equipment and physical environment were conducive to learning. Participants reported that simulation-based training and the use of a standardized checklist during facilitated debriefing were very helpful and effective for sedation training. Additionally, many participants indicated the desire for more simulation-based training.Discussion:Simulation-based sedation training is a feasible, easy to implement, and viable learning technique for acute care physicians.

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