A Novel Application of Healthcare Simulation: Developing and Implementing a Prone Ventilation Protocol for Severe Acute Respiratory Distress Syndrome (ARDS)

Mourad, Bashar; Pakzad, Nick; Pan, Daniel; Montanaro, J.; Karagiannis, B.; Loanzon, Priscilla; Mathew, Joseph; Shapiro, Janet; Kurtz, S.

doi:10.1164/ajrccm-conference.2019.199.1_meetingabstracts.a4779

Cited by 1 publication

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“…All participants verbally confirmed no prior confidence, experience, or knowledge regarding how to manage these events before training. 25 We could not find any literature on emergency management of prone patients or national averages for time involved in resupinating patients to compare with our findings.…”

Section: Resultsmentioning

confidence: 54%

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Using In Situ Simulation to Develop a Prone Positioning Protocol for Patients With ARDS

Montanaro¹

2021

Critical Care Nurse

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Background Acute respiratory distress syndrome carries a 40% mortality rate. Prone positioning remains underused owing to clinicians’ low degree of confidence, concern about the risk of adverse outcomes, and lack of staff competency training. Local Problem and Purpose A prone positioning protocol and educational program were needed in an intensive care unit to achieve compliance with best practices for treating acute respiratory distress syndrome patients. Methods An initial survey was conducted to measure staff confidence and competency in prone positioning. A literature review was performed, and a plan-do-study-act approach was used to develop a protocol through in situ simulation involving mock patients. A training video and a simulation scenario using a high-fidelity manikin were developed to facilitate staff education. Staff were surveyed again after training. Interventions During the simulation scenario, interdisciplinary clinicians learned to apply the protocol and resupinate the patient during a simulated emergency. The training video was later used for “just in time” education minutes before actual prone positioning events. Results A total of 25 critical care nurses, 11 respiratory therapists, and 10 physicians completed the initial survey and simulation training. The survey showed that staff lacked confidence and competency in prone positioning. Staff demonstrated competence during the simulation sessions, and posttraining surveys indicated increased confidence. After the educational program, prone positioning was successfully used for 6 critically ill acute respiratory distress syndrome patients. Conclusions In situ simulation and interdisciplinary collaboration increase standardization of high-risk, underused procedures, improving staff confidence and competence as well as patient safety.

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Section: Resultsmentioning

confidence: 54%

“…The posttraining survey results revealed no significant change in medical knowledge. 25 The average time to recognition of a medical code was 19.3 seconds. The average time to resupinate a patient was 44 seconds.…”

Section: Resultsmentioning

confidence: 99%

Using In Situ Simulation to Develop a Prone Positioning Protocol for Patients With ARDS

Montanaro¹

2021

Critical Care Nurse

View full text Add to dashboard Cite

show abstract

A Novel Application of Healthcare Simulation: Developing and Implementing a Prone Ventilation Protocol for Severe Acute Respiratory Distress Syndrome (ARDS)

Cited by 1 publication

References 0 publications

Using In Situ Simulation to Develop a Prone Positioning Protocol for Patients With ARDS

Using In Situ Simulation to Develop a Prone Positioning Protocol for Patients With ARDS

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