Can Simulation Improve Teamwork and Clinical Outcomes in Pediatric Emergencies?

2.50
Hdl Handle:
http://hdl.handle.net/10755/162536
Type:
Presentation
Title:
Can Simulation Improve Teamwork and Clinical Outcomes in Pediatric Emergencies?
Abstract:
Can Simulation Improve Teamwork and Clinical Outcomes in Pediatric Emergencies?
Conference Sponsor:Emergency Nurses Association
Conference Year:2009
Author:Newell-Helfant, Patricia, RNC, MS, CPNP
P.I. Institution Name:St. Peter's Hospital
Title:Clinical Nurse Specialist
Contact Address:315 South Manning Blvd., Albany, NY, 12208, USA
Contact Telephone:518-525-1395
Co-Authors:Celeste Des Champs, RN, MS, CNAA-BC; Geraldine Vickers, RN, AAS; Maureen Cavanagh, RN, MS, MA, C-EFM
[Annual Conference] Clinical Topic: Each day Emergency Department providers face the potential of responding to pediatric emergencies. The situation is even more demanding in the community hospital setting where pediatric emergencies are rare and the skills of clinical staff are harder to develop and maintain. Little is written in the Nursing literature about the effectiveness of simulation and crisis resource management training on team functioning and clinical outcomes in the pediatric population. There is a growing use of simulation training in the areas of anesthesia and perinatal patient safety. Modeled on the successful crew resource management and simulation training of the airline industry, these clinical efforts have shown promise in the initial outcomes of decreased adverse events and increased staff confidence in the safety of their environments.

Implementation: Building on the hospital's successful experience with perinatal emergency simulation, a collaborative quality improvement project involving the Emergency Department and the Women's and Children's division of a large acute care community hospital was designed to improve the skill and confidence of staff handling the infrequent pediatric emergency. A simulated emergency with a pediatric mannequin, followed by discussion and instruction in crisis resource management communication was initiated in 2008. Nursing and Medical staff from the Emergency Department and Pediatric Unit, along with Respiratory Therapy, nursing students and house staff were included. The drills simulate scenarios involving infants with respiratory failure and hypovolemic shock. The mannequin is a computer driven nine month old infant and can breathe, cry and has palpable pulses. Scenarios can be adapted in real time as a response to participant interventions. Debriefing the team's performance during each of the scenarios is taught with the expectation that this will also be assimilated into practice.

Outcomes: The Safety Attitude Questionnaire - Teamwork and Safety Climate Survey developed by the University of Texas (Sexton et. al, 2006) was administered prior to the simulation experience to gauge the attitudes of staff toward the current practice environment. One year after staff complete the drill experience, they will be re-surveyed with the tool to gauge improvement. In addition, clinical outcomes such as time from admission to initiation of emergency interventions, and need for transfer to the regional pediatric center are being tracked related to infants who present to the emergency department with one of the simulation scenarios. These outcomes will be compared to a like sample of infants from the preceding year.

Recommendations: Based upon initial response to the training, further research is needed to validate clinical outcomes which can be associated with simulation training. In addition, the effect of simulation on staff attitudes regarding the safety of their environment is suggested by initial narrative results. Appropriateness of the Safety Attitude Questionnaire - Teamwork and Climate Survey in this population needs further validation. Finally, the role of simulation in the training of both nursing and medical students appears to enhance the confidence of these beginning level practitioners in participating in pediatric emergencies.

Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleCan Simulation Improve Teamwork and Clinical Outcomes in Pediatric Emergencies?en_GB
dc.identifier.urihttp://hdl.handle.net/10755/162536-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Can Simulation Improve Teamwork and Clinical Outcomes in Pediatric Emergencies?</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2009</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Newell-Helfant, Patricia, RNC, MS, CPNP</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">St. Peter's Hospital</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Clinical Nurse Specialist</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">315 South Manning Blvd., Albany, NY, 12208, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">518-525-1395</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">pnewell-helfant@sphcs.org</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Celeste Des Champs, RN, MS, CNAA-BC; Geraldine Vickers, RN, AAS; Maureen Cavanagh, RN, MS, MA, C-EFM</td></tr><tr><td colspan="2" class="item-abstract">[Annual Conference] Clinical Topic: Each day Emergency Department providers face the potential of responding to pediatric emergencies. The situation is even more demanding in the community hospital setting where pediatric emergencies are rare and the skills of clinical staff are harder to develop and maintain. Little is written in the Nursing literature about the effectiveness of simulation and crisis resource management training on team functioning and clinical outcomes in the pediatric population. There is a growing use of simulation training in the areas of anesthesia and perinatal patient safety. Modeled on the successful crew resource management and simulation training of the airline industry, these clinical efforts have shown promise in the initial outcomes of decreased adverse events and increased staff confidence in the safety of their environments. <br/><br/>Implementation: Building on the hospital's successful experience with perinatal emergency simulation, a collaborative quality improvement project involving the Emergency Department and the Women's and Children's division of a large acute care community hospital was designed to improve the skill and confidence of staff handling the infrequent pediatric emergency. A simulated emergency with a pediatric mannequin, followed by discussion and instruction in crisis resource management communication was initiated in 2008. Nursing and Medical staff from the Emergency Department and Pediatric Unit, along with Respiratory Therapy, nursing students and house staff were included. The drills simulate scenarios involving infants with respiratory failure and hypovolemic shock. The mannequin is a computer driven nine month old infant and can breathe, cry and has palpable pulses. Scenarios can be adapted in real time as a response to participant interventions. Debriefing the team's performance during each of the scenarios is taught with the expectation that this will also be assimilated into practice. <br/><br/>Outcomes: The Safety Attitude Questionnaire - Teamwork and Safety Climate Survey developed by the University of Texas (Sexton et. al, 2006) was administered prior to the simulation experience to gauge the attitudes of staff toward the current practice environment. One year after staff complete the drill experience, they will be re-surveyed with the tool to gauge improvement. In addition, clinical outcomes such as time from admission to initiation of emergency interventions, and need for transfer to the regional pediatric center are being tracked related to infants who present to the emergency department with one of the simulation scenarios. These outcomes will be compared to a like sample of infants from the preceding year.<br/><br/>Recommendations: Based upon initial response to the training, further research is needed to validate clinical outcomes which can be associated with simulation training. In addition, the effect of simulation on staff attitudes regarding the safety of their environment is suggested by initial narrative results. Appropriateness of the Safety Attitude Questionnaire - Teamwork and Climate Survey in this population needs further validation. Finally, the role of simulation in the training of both nursing and medical students appears to enhance the confidence of these beginning level practitioners in participating in pediatric emergencies. <br/><br/></td></tr></table>en_GB
dc.date.available2011-10-27T10:29:51Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:29:51Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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