SC32 Moving to In-situ Simulation on Neonatal Unit. (3rd November 2019)

• Record Type: Journal Article
• Authors: Peterson, Jennifer; Gottstein, Ruth; Ranganna, Ranganath
• Is Part Of: BMJ simulation & technology enhanced learning. Volume 5(2019)Supplement 2
• Page Start: A38
• Page End: A38
• Publication Date: 2019-11-03
• Subjects: Medicine -- Simulation methods -- Periodicals; Medical innovations -- Periodicals; 610.113
• DOI: 10.1136/bmjstel-2019-aspihconf.69
• Languages: English
• ISSNs: 2056-6697

Abstract

Abstract : Background: We have a regular weekly programme of simulation within the Neonatal Unit. These sessions involve nursing and medical staff and are well received and valued by the team. However, the sessions currently take place in an education room, rather than in-situ. We felt that our sessions would benefit from moving to an in-situ approach as this would increase realism for participating staff, and would allow us to detect latent safety threats. Risk assessment: Use of 'real' equipment: there have been many simulation articles reviewing the safety aspects of introducing simulation equipment, eg. equipment which may be old/obsolete/damaged into 'real' clinical areas. We felt that using simulation equipment (other than the manikin) in a real clinical area would introduce an unacceptable risk of potential harm if confused or mixed up with real clinical equipment. Therefore, the equipment used in our in–stiu simulation should be real equipment. This would increase the cost per simulation session, but would help identify latent safety threats of equipment and improve staff familiarity with equipment. Impact on the unit: In–situ simulation has the potential to have an impact on the running of the rest of the unit if occurring in a space directly adjacent to other areas where 'real' patient care is happening. In our simulations, the staff involved in the sessions are rostered to attend and are freed from clinical duties. We concluded that having in–situ session within intensive care rooms would be too disruptive, but that sessions could be successfully implemented in HDU/SCBU rooms with minimal impact on patient care. Impact on parental mental health: there is recent significant evidence documenting the impact of NICU on parental mental health. We would not want to exacerbate this by exposing parents to neonatal deteriorations if they were in the room that the in–situ simulation was happening. We therefore, wanted to gather parental views before implementing an in–situ programme. Summary of education programme: Parent were invited to complete a questionnaire on their views towards in-situ simulation on NICU (April-May 2019). The overwhelming majority of parents polled were strongly supportive of the plan. We have had 15 respondents so far. We now plan to run our first session in-situ simulation at the end of the month and could present our findings at ASPiH in November. References: Patterson MD, Blike GT, Nadkarni VM. In Situ Simulation: Challenges and Results. In: Henriksen K, Battles JB, Keyes MA, et al ., editors. Advances in Patient Safety: New Directions and Alternative Approaches (Vol. 3: Performance and Tools). Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Aug. Available from: https://www.ncbi.nlm.nih.gov/books/NBK43682/ Fent, Graham, Blythe, James, Farooq, Omer, Purva, Mak. In situ simulation as a tool for patient safety: a systematic review identifying how it is used and its effectiveness. BMJ Simulation and Technology Enhanced Learning 2015. 1. 10.1136/bmjstel-2015-000065.