What Is the Impact of In Situ Simulation on Delays in Defibrillation Among Nurses on an Intermediate Critical Care Unit (ICCU)?

2021 ◽  
Author(s):  
Patricia A. Toth
Keyword(s):  
Critical Care ◽  
Critical Care Unit ◽  
In Situ Simulation ◽  
The Impact

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.

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.

Abstract 301: Identifying Critical Care Unit Organizational Factors That Impact Cardiac Arrest Incidence and Outcomes: A Report From the Pediatric Cardiac Critical Care Consortium

Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
Javier J Lasa ◽  
Jeffrey A Alten ◽  
Mousumi Banerjee ◽  
Wenying Zhang ◽  
Kurt Schumacher ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Critical Care ◽  
Critical Care Unit ◽  
Organizational Factors ◽  
Full Time ◽  
Provider Education ◽  
Multinomial Regression ◽  
Clinical Registry ◽  
The Impact ◽  
Cardiac Critical Care

Introduction: Patient factors leading to cardiac arrest (CA) in the pediatric cardiac critical care unit (CICU) are well understood, but may be unmodifiable. Our understanding of the impact of CICU organizational factors (OFs) such as staffing models, health care provider education, and CICU bed management is limited. The association between these potentially modifiable CICU OFs on CA prevention and rescue outcomes is unknown. Hypothesis: CICU OFs associate with CA prevention and rescue. Methods: Retrospective analysis of Pediatric Cardiac Critical Care Consortium (PC4) clinical registry including data for all patients admitted to CICUs from August 2014 to March 2019. Prevention was defined as the prevalence of subjects not suffering CA. Rescue was defined as survival after CA. CICU OFs were captured via questionnaire distributed to PC4 participants in 2017 (100% response). Stratified, multivariable regression was used to evaluate associations between OFs and outcome in medical and surgical admission subgroups: competing time-to-events framework (to assess prevention) and multinomial regression (to assess rescue), accounting for clustering of patients within hospitals. Results: We analyzed 54,521 CICU admissions (59% surgical, 41% medical) from 29 hospitals with 1398 CA events (2.5%). We studied 12 OFs that varied across centers after accounting for collinearity. For both surgical and medical admissions, lower average daily occupancy (<80%) was associated with better arrest prevention for all admissions, and better rescue in the surgical cohort. Increased proportion of nurses with >2 years experience, increased proportion of nurses with critical care certification, % of full-time intensivists, % of intensivists with critical care training, dedicated respiratory therapists, quality/safety resources, and annual CICU admission volume were not associated with improved prevention or rescue. Conclusion: Our multi-institutional analysis suggests that lower average CICU occupancy was the only consistent OF evaluated that was associated with CA prevention and rescue. CICUs that have average daily occupancy >80% may need specific strategies to mitigate the risks of CA.

The Impact of Hospital-Based In Situ Simulation on Nurses’ Recognition and Intervention of Patient Deterioration

2019 ◽  
Vol 35 (1) ◽  
pp. 18-24 ◽  
Author(s):  
Corinne Lee ◽  
Jolé L. Mowry ◽  
Susan E. Maycock ◽  
Marie E. Colaianne-Wolfer ◽  
Suzanne W. Knight ◽  
...  
Keyword(s):  
In Situ Simulation ◽  
Patient Deterioration ◽  
The Impact

scholarly journals The impact of an obstetrician-led, labor ward critical care unit: A prospective comparison of outcomes before and after establishment

2019 ◽  
Vol 13 (3) ◽  
pp. 132-136
Author(s):  
Eduard J Langenegger ◽  
DR Hall ◽  
F Mattheyse ◽  
J Harvey
Keyword(s):  
Critical Care ◽  
Critical Care Unit ◽  
Maternal Morbidity ◽  
Prospective Comparison ◽  
Labor Ward ◽  
Evaluation Scores ◽  
Maternal Morbidity And Mortality ◽  
Before And After ◽  
One Year ◽  
The Impact

Objective To investigate the outcomes of critically ill obstetric patients managed in a obstetric critical care unit in South Africa. Methods Patients with severe maternal morbidity managed in the labor ward of Tygerberg Hospital were studied over three months before the establishment of the obstetrician-led obstetric critical care unit. One year later, patients managed in the obstetric critical care unit were studied using the same methods. The primary outcome measures were maternal morbidity and mortality. Results In the before-obstetric critical care unit prospective audit 63 patients met criteria for obstetric critical care. During the second period 60 patients were admitted to the obstetric critical care unit. There were no significant differences between the groups in baseline characteristics, admission indications or Acute Physiology and Chronic Health Evaluation scores. Continuous positive airway pressure ( p < 0.01) was utilized more in the second group. Seven deaths occurred in the first, but none in the second group ( p = 0.01). Conclusion The establishment of an obstetrician-led obstetric critical care unit facilitated a decrease in maternal mortality. Trial registration: Not applicable.

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