O34 Environmental priming improves performance in simulated paediatric emergencies – a randomised control trial. (3rd November 2019)

• Record Type: Journal Article
• Authors: McNaughten, Ben; Storey, Lesley; Corkin, Doris; Cardwell, Pauline; Thompson, Andrew; Bourke, Thomas; O'Donoghue, Dara
• Is Part Of: BMJ simulation & technology enhanced learning. Volume 5(2019)Supplement 2
• Page Start: A19
• Page End: A20
• Publication Date: 2019-11-03
• Subjects: Medicine -- Simulation methods -- Periodicals; Medical innovations -- Periodicals; 610.113
• DOI: 10.1136/bmjstel-2019-aspihconf.32
• Languages: English
• ISSNs: 2056-6697

Abstract

Abstract : Introduction: Time delays in the delivery of emergency treatment in a resuscitation can be detrimental to patient care. 1 Multiple factors have been implicated as causes of such delays. These include hospital related factors such as the time taken to access emergency equipment. 2 Recommendations have previously been made regarding standardisation of resuscitation trolleys. 3 To date there have been no studies evaluating the effect of environmental priming on performance in simulated emergencies. This study aimed to evaluate the effect of environmental priming impact on student performance in a simulated paediatric emergency. Methods: Ethical approval for the study was obtained. SimBaby is an inter-professional educational module in which undergraduate nursing and medical students participate in simulated paediatric emergencies. We randomised students participating in SimBaby into primed or un-primed groups. Those in the primed arm received a tour of the sim-suite in advance of the session and had access to an online video tour of the sim-suite. Students then undertook a simulated scenario based on a child with meningococcal septicaemia. The time taken to achieve five of the six key clinical interventions outlined in the Paediatric Sepsis Six protocol were recorded. A selection of groups were then randomly selected to undertake semi-structured interviews with a psychologist. Data was analysed using thematic analysis. Results: The primed students were quicker to all five key clinical interventions and significantly quicker to achieving IV access, administration of antibiotics and seeking senior help (p<0.05). (table 1 ) Interestingly students participating in the semi-structured interviews displayed a degree of cognitive dissonance suggesting that they didn't feel that they have gained any specific advantage from being primed. Un-primed medical and nursing students did not feel disadvantaged by not being primed. Discussions/Conclusions: These findings suggest that familiarity with the clinical environment may improve clinical performance and subsequently impact positively on patient outcomes even if participants are not always aware of the benefit this may confer. This may have implications for considering standardisation of resuscitation areas within healthcare settings. In addition it may highlight the importance of local induction and perhaps helps to promote the use of in-situ-simulation in familiarising staff with the local environment. References: Chan P, Krumholz H, Nichol G, et al. Delayed time to defibrillation after in-hospital cardiac arrest. N Engl J Med 2008;358:9–17. Pedley R, Whitehouse A, Hammond S. Improving room layouts for venepuncture, cannulation and ABG equipment on surgical wards. BMJ Quality Improvement Reports 2014; u554.w477 doi: 10.1136/bmjquality.u554.w477 Royal College of Anaesthetists, Royal College of Physicians of London, Intensive Care Society, Resuscitation Council (UK). Cardiopulmonary resuscitation: standards for clinical practice and training. Resuscitation Council (UK).Published October 2004, updated June 2008.