0179 ‘In situ’ simulation: testing the system and environment for patient safety in a new renal satellite unit prior to opening

2014 ◽  
Author(s):  
Julie Hannah ◽  
Michael Canavan
Keyword(s):  
Patient Safety ◽  
In Situ Simulation ◽  
Simulation Testing ◽  
Satellite Unit

scholarly journals IMPROVING SYSTEM READINESS, STAFF PREPAREDNESS AND PATIENT SAFETY IN A NEW SINGLE FAMILY ROOM NICU THROUGH IN SITU SIMULATION

2018 ◽  
Vol 23 (suppl_1) ◽  
pp. e16-e16
Author(s):  
Ahmed Moussa ◽  
Audrey Larone-Juneau ◽  
Laura Fazilleau ◽  
Marie-Eve Rochon ◽  
Justine Giroux ◽  
...  
Keyword(s):  
Patient Safety ◽  
Repeated Measures ◽  
Large Scale ◽  
Multidisciplinary Teams ◽  
Single Family ◽  
In Situ Simulation ◽  
Ensure Patient Safety ◽  
System Readiness ◽  
Dependent Samples

Abstract BACKGROUND Transitions to new healthcare environments can negatively impact patient care and threaten patient safety. Immersive in situ simulation conducted in newly constructed single family room (SFR) Neonatal Intensive Care Units (NICUs) prior to occupancy, has been shown to be effective in testing new environments and identifying latent safety threats (LSTs). These simulations overlay human factors to identify LSTs as new and existing process and systems are implemented in the new environment OBJECTIVES We aimed to demonstrate that large-scale, immersive, in situ simulation prior to the transition to a new SFR NICU improves: 1) systems readiness, 2) staff preparedness, 3) patient safety, 4) staff comfort with simulation, and 5) staff attitude towards culture change. DESIGN/METHODS Multidisciplinary teams of neonatal healthcare providers (HCP) and parents of former NICU patients participated in large-scale, immersive in-situ simulations conducted in the new NICU prior to occupancy. One eighth of the NICU was outfitted with equipment and mannequins and staff performed in their native roles. Multidisciplinary debriefings, which included parents, were conducted immediately after simulations to identify LSTs. Through an iterative process issues were resolved and additional simulations conducted. Debriefings were documented and debriefing transcripts transcribed and LSTs classified using qualitative methods. To assess systems readiness and staff preparedness for transition into the new NICU, HCPs completed surveys prior to transition, post-simulation and post-transition. Systems readiness and staff preparedness were rated on a 5-point Likert scale. Average survey responses were analyzed using dependent samples t-tests and repeated measures ANOVAs. RESULTS One hundred eight HCPs and 24 parents participated in six half-day simulation sessions. A total of 75 LSTs were identified and were categorized into eight themes: 1) work organization, 2) orientation and parent wayfinding, 3) communication devices/systems, 4) nursing and resuscitation equipment, 5) ergonomics, 6) parent comfort; 7) work processes, and 8) interdepartmental interactions. Prior to the transition to the new NICU, 76% of the LSTs were resolved. Survey response rate was 31%, 16%, 7% for baseline, post-simulation and post-move surveys, respectively. System readiness at baseline was 1.3/5,. Post-simulation systems readiness was 3.5/5 (p = 0.0001) and post-transition was 3.9/5 (p = 0.02). Staff preparedness at baseline was 1.4/5. Staff preparedness post-simulation was 3.3/5 (p = 0.006) and post-transition was 3.9/5 (p = 0.03). CONCLUSION Large-scale, immersive in situ simulation is a feasible and effective methodology for identifying LSTs, improving systems readiness and staff preparedness in a new SFR NICU prior to occupancy. However, to optimize patient safety, identified LSTs must be mitigated prior to occupancy. Coordinating large-scale simulations is worth the time and cost investment necessary to optimize systems and ensure patient safety prior to transition to a new SFR NICU.

scholarly journals Patient safety culture improves during an in situ simulation intervention: a repeated cross-sectional intervention study at two hospital sites

2021 ◽  
Vol 10 (1) ◽  
pp. e001183
Author(s):  
Anders Schram ◽  
Charlotte Paltved ◽  
Karl Bang Christensen ◽  
Gunhild Kjaergaard-Andersen ◽  
Hanne Irene Jensen ◽  
...  
Keyword(s):  
Patient Safety ◽  
Safety Culture ◽  
Intervention Study ◽  
Patient Safety Culture ◽  
Cross Sectional ◽  
In Situ Simulation ◽  
Culture Dimensions ◽  
Scale Scores ◽  
Safety Attitude

ObjectivesThis study aimed to investigate staff’s perceptions of patient safety culture (PSC) in two Danish hospitals before and after an in situ simulation intervention.DesignA repeated cross-sectional intervention study.SettingTwo Danish hospitals. Hospital 1 performs emergency functions, whereas hospital 2 performs elective functions.ParticipantsA total of 967 healthcare professionals were invited to participate in this study. 516 were employed in hospital 1 and 451 in hospital 2. Of these, 39 were trained as simulation instructors.InterventionA 4-day simulation instructor course was applied. Emphasis was put on team training, communication and leadership. After the course, instructors performed simulation in the hospital environment. No systematic simulation was performed prior to the intervention.Main outcome measuresThe Safety Attitude Questionnaire investigating PSC was applied prior to the intervention and again 4 and 8 weeks after intervention. The proportion of participants with a positive attitude and mean scale scores were measured as main outcomes.ResultsThe response rate varied from 63.6% to 72.0% across surveys and hospitals. Baseline scores were generally lower for hospital 1. The proportion of staff with positive attitudes in hospital 1 improved by ≥5% in five of six safety culture dimensions, whereas only two dimensions improved by ≥5% in hospital 2. The mean scale scores improved significantly in five of six safety culture dimensions in hospital 1, while only one dimension improved significantly in hospital 2.ConclusionsSafety attitude outcomes indicate an improvement in PSC from before to after the in situ simulation intervention period. However, it is possible that an effect is more profound in an acute care hospital versus an elective setting.

scholarly journals A Neonatal Intensive Care Unit’s Experience with Implementing an In-Situ Simulation and Debriefing Patient Safety Program in the Setting of a Quality Improvement Collaborative

Children ◽  
2020 ◽  
Vol 7 (11) ◽  
pp. 202
Author(s):  
Mary Eckels ◽  
Terry Zeilinger ◽  
Henry C. Lee ◽  
Janine Bergin ◽  
Louis P. Halamek ◽  
...  
Keyword(s):  
Patient Safety ◽  
Intensive Care ◽  
Quality Improvement ◽  
Neonatal Intensive Care ◽  
Quality Care ◽  
Neonatal Resuscitation ◽  
Healthcare Team ◽  
In Situ Simulation ◽  
Implementation Phase

Extensive neonatal resuscitation is a high acuity, low-frequency event accounting for approximately 1% of births. Neonatal resuscitation requires an interprofessional healthcare team to communicate and carry out tasks efficiently and effectively in a high adrenaline state. Implementing a neonatal patient safety simulation and debriefing program can help teams improve the behavioral, cognitive, and technical skills necessary to reduce morbidity and mortality. In Simulating Success, a 15-month quality improvement (QI) project, the Center for Advanced Pediatric and Perinatal Education (CAPE) and California Perinatal Quality Care Collaborative (CPQCC) provided outreach and training on neonatal simulation and debriefing fundamentals to individual teams, including community hospital settings, and assisted in implementing a sustainable program at each site. The primary Aim was to conduct two simulations a month, with a goal of 80% neonatal intensive care unit (NICU) staff participation in two simulations during the implementation phase. While the primary Aim was not achieved, in-situ simulations led to the identification of latent safety threats and improvement in system processes. This paper describes one unit’s QI collaborative experience implementing an in-situ neonatal simulation and debriefing program.

Using In Situ Simulation to Identify and Resolve Latent Environmental Threats to Patient Safety

2010 ◽  
Vol 19 (3) ◽  
pp. 226-230 ◽  
Author(s):  
William R. Hamman ◽  
Beth M. Beaudin-Seiler ◽  
Jeffrey M. Beaubien ◽  
Amy M. Gullickson ◽  
Krystyna Orizondo-Korotko ◽  
...  
Keyword(s):  
Patient Safety ◽  
In Situ Simulation ◽  
Environmental Threats

scholarly journals Simulation-Based Training Program to Improve Cardiopulmonary Resuscitation and Teamwork Skills for the Urgent Care Clinic Staff

2021 ◽  
Author(s):  
Rupert Biacora Laco ◽  
Wilma Powell Stuart
Keyword(s):  
Patient Safety ◽  
Urgent Care ◽  
Improvement Project ◽  
Care Clinic ◽  
In Situ Simulation ◽  
Simulation Based ◽  
Urgent Care Clinic ◽  
Teamwork Skills ◽  
Cpr Training

ABSTRACT Introduction Lack of high-quality cardiopulmonary resuscitation (CPR) and effective team communication during cardiovascular emergencies could lead to poor patient outcomes and adverse events. Studies have shown that CPR psychomotor skills declined 3 months and plateaued up to 6 months after the completion of CPR training. The Urgent Care Clinic (UCC) interprofessional staff did not receive consistent training on CPR and teamwork skills beyond what was received from the biannual American Red Cross (ARC) Basic Life Support (BLS) training and semiannual Resuscitative Care Function mock cardiac arrest. Most participants took their last CPR training for more than 6 months (n = 12, 67%), between 3 and 6 months (n = 2, 11%), and within the last 3 months before the pre-intervention period (n = 4, 22%). The purpose of the project was to form an interprofessional team to lead the development and implementation of a theory- and evidence-based simulation-based training program to improve CPR and teamwork skills while enhancing patient safety and emergency medical readiness in the hospital and UCC. Materials and Methods The quality improvement project utilized an interprofessional in situ simulation-based training to improve participants’ CPR and teamwork skills. The UCC physicians, nurses, and medical technicians completed a CPR and teamwork simulation-based training with a high-fidelity mannequin, pre-simulation preparation, briefing, and debriefing. The project collected pre-intervention and post-intervention data for CPR competence and teamwork perceptions. A paired t-test was used to assess differences in participant CPR skills and Team Strategies to Enhance Performance and Patient Safety Teamwork Perceptions Questionnaire responses before and after the simulation-based training intervention. The 59th Medical Wing and the University of South Alabama Institutional Review Boards approved the quality improvement project. Results A total of 18 participants completed the ARC BLS and Team Strategies to Enhance Performance and Patient Safety simulation-based training. Most participants were medical technicians (n = 8, 44%), followed by physicians (n = 5, 28%) and (n = 5, 28%) nurses. There was a statistical significance in participants’ ARC BLS scores, with a pre-simulation mean score of 45.42 and a post-simulation mean score of 89.21 (P = .000, 95% CI = 36.89-50.68). For Team Strategies to Enhance Performance and Patient Safety teamwork perceptions, there was a statistically significant increase in the participants’ teamwork perception levels, with a pre-simulation mean score of 4.61 and a post-simulation mean score of 4.86 (P = .000, 95% CI = 0.20-0.31). Conclusions Our results demonstrated that the participants’ ARC BLS scores and UCC’s team perceptions have increased after in situ simulation-based training. We did not assess the ideal time for re-training. We recommend a 3- to 6-month post-training assessment to determine the optimal time for a CPR and teamwork refresher training. A high-fidelity simulation-based program with trained facilitators that assess the healthcare providers’ CPR and teamwork skills could enhance the delivery of high-quality CPR and execution of effective teamwork skills in their workplace.

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