scholarly journals In situ simulation in a time of pandemic

2021 ◽  
Vol 6 (3) ◽  
pp. 95-98
Author(s):  
Shin Ying Thng ◽  
Bao Yu Geraldine Leong ◽  
Guat Keng Yvonne Goh ◽  
Ching Ching Elaine Tan ◽  
Jimmy Kock Keng Goh ◽  
...  
Keyword(s):  
Emergency Department ◽  
High Risk ◽  
Healthcare Team ◽  
Risk Environment ◽  
Work Processes ◽  
In Situ Simulation ◽  
Resuscitation Room ◽  
Patients At Risk ◽  
Set Up

Introduction: Singapore was one of the earliest countries affected by the COVID-19 outbreak, requiring our emergency department to respond urgently to this surge. A designated Fever Area (FA) with a resuscitation room was rapidly set up to manage patients at risk of COVID-19. Our paper describes measures put into this new area to optimise safety outcomes of these patients. Methods: Plan-Do-Study-Act (PDSA) cycles incorporating in-situ simulation in the FA resuscitation room were conducted. Using varied resuscitation scenarios and facilitated debriefing, we identified safety gaps and took immediate steps to rectify them in a collaborative manner involving various respective stakeholders. Results: Following reflective debriefing and studying of work processes, latent safety threats were identified resulting in successful improvements and modifications to protocols, equipment, staffing and processes in the FA resuscitation area. Conclusion: PDSA cycles involving in-situ simulation helped to identify safety threats and refine work processes in a newly set up FA facility. As a result, our healthcare team was more prepared to manage the complexities of COVID-19 patients in a high-risk environment.

scholarly journals In situ simulation: detection of safety threats and teamwork training in a high risk emergency department

2012 ◽  
Vol 22 (6) ◽  
pp. 468-477 ◽  
Author(s):  
Mary D Patterson ◽  
Gary Lee Geis ◽  
Richard A Falcone ◽  
Thomas LeMaster ◽  
Robert L Wears
Keyword(s):  
Emergency Department ◽  
High Risk ◽  
In Situ Simulation

scholarly journals LO044: Stress-testing the resuscitation room: latent threats to patient safety identified during interprofessional in-situ simulation in the emergency department

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S45-S45
Author(s):  
G. Mastoras ◽  
C. Poulin ◽  
L. Norman ◽  
B. Weitzman ◽  
A. Pozgay ◽  
...  
Keyword(s):  
Emergency Department ◽  
Patient Safety ◽  
Interprofessional Education ◽  
Healthcare Professionals ◽  
Tertiary Care ◽  
Healthcare Team ◽  
Monthly Basis ◽  
In Situ Simulation ◽  
Training Tool

Introduction: Emergency Department (ED) resuscitation is a complex, high-stakes procedure where positive outcomes depend upon effective interactions between the healthcare team, the patient, and the environment. To this end, resuscitation teams work in spaces designed to optimize workflows and ensure that necessary treatments and skillsets are available when required. However, systematic failures in this environment cannot always be adequately anticipated, exposing patients to opportunities for harm. As part of a new interprofessional education initiative, this prospective, observational study sought to characterize latent threats to patient safety (LST’s) identified during the delivery of in-situ, simulated resuscitations in two Canadian, tertiary care, academic Emergency Departments. Methods: In-situ simulation sessions were delivered on a monthly basis in the EDs of each hospital campus, during which a variety of simulated resuscitation scenarios were run with distinct teams of ED healthcare professionals. A research assistant was present throughout each session and documented LST’s identified by simulation facilitators and participants during the case and debriefing. Data were entered into a master table and grouped thematically for analysis. Results: After a pilot run-in, 10 in-situ simulation sessions were delivered, involving 27 cases and reaching 180 ED healthcare professionals (25 attending MD, 37 resident MD, 59 RN, 24 RT). 83 latent safety threats were identified through these sessions (mean 3.1 LSTs per case) of which 52 were determined to be “actionable”. Corrective mechanisms have been initiated in 72% of these cases (e.g., new education campaigns and in-servicing, equipment provisioning, equipment checklists). Conclusion: In-situ simulation, beyond its role as a training tool for developing Non-Technical and Crisis Resource Management skills, can be effectively used to identify systematic deficits and knowledge gaps that could expose critically ill patients to harm. Effective quality improvement and continuing education programs are essential to translate these findings into more resilient patient care.

scholarly journals SP10.1.7 The Important Role of In-Situ Simulation in Preparing Surgeons for the COVID-19 Pandemic

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Pierre Montauban ◽  
Charannya Balakumar ◽  
Jaideep Rait ◽  
Prizzi Zarsadias ◽  
Sara Iqbal ◽  
...  
Keyword(s):  
High Risk ◽  
In Situ Simulation ◽  
Level Of Confidence ◽  
Effective Training ◽  
Before And After ◽  
Quasi Experimental ◽  
Surgical Teams ◽  
Imminent Threat ◽  
The Impact

Abstract Background Effective training is vital when facing viral outbreaks such as the SARS Coronavirus 2 (SARS-CoV-2) outbreak of 2019. The objective of this study was to measure the impact of in-situ simulation on the confidence of the surgical teams of two hospitals in assessing and managing acutely unwell surgical patients who are high-risk or confirmed to have COVID-19. Methods This was a quasi-experimental study with a pretest-posttest design. The surgical teams at each hospital participated in multi-disciplinary simulation sessions to explore the assessment and management of a patient requiring emergency surgery who is high risk for COVID-19. The participants were surveyed before and after receiving simulation training to determine their level of confidence on a Visual Analog Scale (VAS) for the premise stated in each of the nine questions in the survey, which represented multiple aspects of the care of these patients. Results 27 participants responded the pre-simulation survey and 24 the one post-simulation. The level of confidence (VAS score) were statistically significantly higher for all nine questions after the simulation. Specific themes were identified for further training and changes in policy. Conclusion In-situ simulation is an effective training method. Its versatility allows it to be set up quickly as rapid-response training in the face of an imminent threat. In this study, it improved the preparedness of two surgical teams for the challenges of the COVID-19 pandemic.

In situ simulation in the management of anaphylaxis in a pediatric emergency department

2018 ◽  
Vol 14 (1) ◽  
pp. 127-132 ◽  
Author(s):  
Simona Barni ◽  
Francesca Mori ◽  
Mattia Giovannini ◽  
Marco de Luca ◽  
Elio Novembre
Keyword(s):  
Emergency Department ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department ◽  
In Situ Simulation

scholarly journals COVID-19 Emergency Department Protocols: Experience of Protocol Implementation Through in-situ Simulation

2020 ◽  
Vol Volume 12 ◽  
pp. 293-303 ◽  
Author(s):  
Anmol Purna Shrestha ◽  
Abha Shrestha ◽  
Taylor Sonnenberg ◽  
Roshana Shrestha
Keyword(s):  
Emergency Department ◽  
Protocol Implementation ◽  
In Situ Simulation

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.

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