PG6 Non-invasive ventilation training during the COVID-19 pandemic – a single-centre simulation programme. (10th November 2020)

• Record Type: Journal Article
• Authors: Marley, Alexander; Liu, Lucy; John, Sini; Dimmock, Val
• Is Part Of: BMJ simulation & technology enhanced learning. Volume 6(2020)Supplement 1
• Page Start: A33
• Page End: A33
• Publication Date: 2020-11-10
• Subjects: Medicine -- Simulation methods -- Periodicals; Medical innovations -- Periodicals; 610.113
• DOI: 10.1136/bmjstel-2020-aspihconf.55
• Languages: English
• ISSNs: 2056-6697

Abstract

Abstract : Introduction: COVID-19 is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It primarily targets the respiratory system, with approximately 14% of patients developing a severe respiratory illness. 1 A subset of patients present with hypoxaemia refractory to oxygen therapy and require non-invasive ventilation (NIV), either for type 1 or type 2 respiratory failure. 2 Given the large numbers of patients presenting to hospitals with COVID-19, it is vital that healthcare staff are well-trained in the use of NIV. This includes non-frontline staff who have been redeployed to emergency and acute care wards as a result of the pandemic. 3 The simulation department at Homerton University Hospital (HUH) have created a half-day NIV simulation training programme in order to achieve this. Description: The HUH NIV simulation training programme has been running since June and has involved 64 healthcare staff over the course of 8 sessions (figure 1 ). Each session lasts half a day and is led by faculty from the simulation department. Numbers of participants have been limited to 8 per session to allow for social distancing. The programme is split into 4 sections: physiology, indications and set-up of NIV; type 1 respiratory failure and continuous positive airway pressure (CPAP); type 2 respiratory failure and bilevel positive airway pressure (BiPAP); and ceiling of care discussions. The programme utilises a variety of educational tools, including lectures, simulations and debriefs. Participants are encouraged to use a 'NIV passport' after the session so that they can continue to improve their skills in their workplace. Feedback so far has been overwhelmingly positive, with the majority of participants answering 'agree' or 'strongly agree' to statements on a post-course questionnaire, including the statement 'I feel more confident with NIV' (table 1 ). Discussion: The HUH NIV simulation training programme has aimed to improve participants' competence and confidence in the use of NIV, as well as their understanding of ceiling of care discussions. These learning objectives are vital given the increased use of NIV to manage respiratory failure secondary to COVID-19. Although there are limitations due to social distancing, we have managed to create a practical approach in delivering training. We believe that this will lead to fewer medical errors and improved patient outcomes when it comes to NIV. The training programme will continue to run at HUH throughout the pandemic. Its simplicity and low-cost means it can easily be utilised by other healthcare providers. References: Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese center for disease control and prevention. JAMA 2020;323(13):1239–1242. Marini JJ, Gattinoni L. Management of COVID-19 respiratory distress. JAMA 2020. Nicholson TW, Talbot NP, Nickol A, Chadwick AJ, Lawton O. Respiratory failure and non-invasive respiratory support during the covid-19 pandemic: an update for re-deployed hospital doctors and primary care physicians. BMJ 2020 January 01;369:m2446.