2.50
Hdl Handle:
http://hdl.handle.net/10755/198334
Title:
The Competency Safety Initiative Room - Low Fidelity Simulation
Abstract:
[ENA Annual Conference 2011 - Evidence-based Practice Presentation] The Competency Safety Initiative Room - Low Fidelity Simulation

Purpose: To explore an innovative approach to enhance safety in the Emergency Department using low fidelity simulation.

Design: This was a patient safety initiative.

Setting: Teaching, urban emergency department with 52,000 annual visits

Participants/Subjects: ED Nursing Director, ED Nurse Manager, ED Nurse Educator and ED Staff Nurses

Methods: Safety concerns were identified by reviewing current National Patient Safety Goals and reviewing reports in the ED’s Medical Event Reporting System. Heparin administration, hand washing, infection control practices, restraint competency, and patient identification were identified as safety issues. Other specific ED focuses were room safety with the suicidal patient, oxygen safety, proper disposal of clean biohazard bags, apnea alarms and tubing labeling. It was important to get the staff engaged in the culture of safety. Literature reviews show that simulation is an effective way to increase awareness and focus on process. Many staff members are familiar with “Crime Scene Investigation” television shows. This ED’s CSI Room took some of the investigative components of the popular series. Each staff member was given a scenario and a clipboard prior to entering the room. They were asked to enter the room the way they would enter an ED room, identify fourteen safety concerns and give the corrective action. A low fidelity mannequin was used as well as “actors” who would also engage the participant to see if they felt empowered to maintain infection control processes. Once they identified all issues, they had completed the safety competency. One objective was to demonstrate safe medication administration: specifically to reduce harm from anticoagulant therapy. The scenario card replicated an ED administration error. The scenario told the participant that the 112 pound “patient” was receiving Heparin infusion. The infusion pump was programmed for 112 kg. Finding this error was the “a ha” moment for many.

Results/Outcomes: The staff evaluated this method of competency verification and found it effective and interactive. The educators evaluating this process found that it was an efficient way of competency verification. Six staff members could be evaluated in the room at once. It took approximately 10 minutes from the time the instructions were given; donning proper PPE, finding the 14 safety concerns and giving the corrective action. Those who struggled finding the “last” safety concern voiced that it left a lasting impression. Staff stated that there was a heightened awareness for demonstrating safe Heparin administration practice.

Implications: With limited time and budget, low fidelity simulation room could be an effective and efficient way to engage staff in safety initiatives surrounding high risk/low volume issues. Although there is no evidence that supports that this intervention prevents Heparin errors, no ED Heparin administration errors have occurred since this intervention in October 2010.






Repository Posting Date:
21-Dec-2011
Date of Publication:
21-Dec-2011

Full metadata record

DC FieldValue Language
dc.titleThe Competency Safety Initiative Room - Low Fidelity Simulationen_GB
dc.identifier.urihttp://hdl.handle.net/10755/198334-
dc.description.abstract[ENA Annual Conference 2011 - Evidence-based Practice Presentation] The Competency Safety Initiative Room - Low Fidelity Simulation<br/><br/>Purpose: To explore an innovative approach to enhance safety in the Emergency Department using low fidelity simulation. <br/><br/>Design: This was a patient safety initiative.<br/><br/>Setting: Teaching, urban emergency department with 52,000 annual visits<br/><br/>Participants/Subjects: ED Nursing Director, ED Nurse Manager, ED Nurse Educator and ED Staff Nurses<br/><br/>Methods: Safety concerns were identified by reviewing current National Patient Safety Goals and reviewing reports in the ED’s Medical Event Reporting System. Heparin administration, hand washing, infection control practices, restraint competency, and patient identification were identified as safety issues. Other specific ED focuses were room safety with the suicidal patient, oxygen safety, proper disposal of clean biohazard bags, apnea alarms and tubing labeling. It was important to get the staff engaged in the culture of safety. Literature reviews show that simulation is an effective way to increase awareness and focus on process. Many staff members are familiar with “Crime Scene Investigation” television shows. This ED’s CSI Room took some of the investigative components of the popular series. Each staff member was given a scenario and a clipboard prior to entering the room. They were asked to enter the room the way they would enter an ED room, identify fourteen safety concerns and give the corrective action. A low fidelity mannequin was used as well as “actors” who would also engage the participant to see if they felt empowered to maintain infection control processes. Once they identified all issues, they had completed the safety competency. One objective was to demonstrate safe medication administration: specifically to reduce harm from anticoagulant therapy. The scenario card replicated an ED administration error. The scenario told the participant that the 112 pound “patient” was receiving Heparin infusion. The infusion pump was programmed for 112 kg. Finding this error was the “a ha” moment for many. <br/><br/>Results/Outcomes: The staff evaluated this method of competency verification and found it effective and interactive. The educators evaluating this process found that it was an efficient way of competency verification. Six staff members could be evaluated in the room at once. It took approximately 10 minutes from the time the instructions were given; donning proper PPE, finding the 14 safety concerns and giving the corrective action. Those who struggled finding the “last” safety concern voiced that it left a lasting impression. Staff stated that there was a heightened awareness for demonstrating safe Heparin administration practice. <br/><br/>Implications: With limited time and budget, low fidelity simulation room could be an effective and efficient way to engage staff in safety initiatives surrounding high risk/low volume issues. Although there is no evidence that supports that this intervention prevents Heparin errors, no ED Heparin administration errors have occurred since this intervention in October 2010.<br/><br/><br/><br/><br/><br/><br/>en_GB
dc.date.available2011-12-21T12:46:05Z-
dc.date.issued2011-12-21T12:46:05Z-
dc.date.accessioned2011-12-21T12:46:05Z-
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