Improving Adherence to a Pediatric Advanced Life Support Supraventricular Tachycardia Algorithm in Community Emergency Departments Following in Situ Simulation

Abstract

Background: Recognition and management of pediatric dysrhythmias is challenging for community emergency department (CED) providers, given their infrequent exposure to these cases. Method: A prospective, interventional study measured adherence of CEDs to pediatric supraventricular tachycardia (SVT) algorithm pre- and postimplementation of an in situ simulation-based collaborative program. CED teams' adherence was scored using a composite adherence score (CAS) based on the number of actions scored correctly on the performance checklist. Results: A total of 74 multiprofessional teams from nine CEDs participated in simulated sessions. Of 367 participants, 12.3% were physicians, 62.1% were RNs, and 25.6% were other providers. The mean CAS improved from 57% to 71%. The ability to identify an SVT rhythm, stable versus unstable SVT, and the correct performance of synchronized cardioversion significantly improved. Conclusion: This study demonstrated improvement in overall adherence of CEDs to pediatric SVT algorithm following a collaborative program in simulated setting. This approach could be adapted to improve the quality of care provided to children. [ J Contin Educ Nurs. 2019;50(9):404–410.]

Improvement of Pediatric Advanced Airway Management in General Emergency Departments After a Collaborative Intervention Program

“…18,19 A series of recent studies successfully demonstrated the effect of in situ simulation on the skills and confidence of health-care providers in general emergency departments in treating various simulated pediatric critical conditions, such as diabetic ketoacidosis, airway management, and supraventricular tachycardia. [11][12][13][14][15] In this study, simulation was used as a tool to assess and improve the process of care provided by interprofessional teams and identifies gaps and opportunities for improvements in the system of care in the general emergency department setting. Subsequently, simulation was used as an improvement tool with which these gaps were addressed with general emergency department leadership through the development of customized performance reports.…”

“…10 In parallel, we previously reported a collaboration program between our pediatric academic medical center and a group of general emergency departments statewide. [11][12][13][14][15] This collaboration, through in situ simulation, education, and quality improvement, aimed to optimize pediatric emergency readiness and quality of care provided in general emergency departments. Participating general emergency departments demonstrated significant improvement in the process of care provided to children in acute care scenarios, including advanced airway management in a simulated setting.…”

Findings From the 2021 Organizational Value of Nursing Professional Development Practice, Part 3

“…Despite calls for demonstration of the value NPD practice brings to healthcare organizations (Harper & Maloney, 2022), evidence of NPD contributions to positive outcomes in children's hospitals is scarce. Although evidence is found of the value of staff education in the literature, in most cases, these data arise from quality improvement projects, both with NPD participation (Benning & Webb, 2019; Hammontree & Kinderknecht, 2022) and without NPD participation (Gavriloff, 2012; Gest, 2021; Kisting et al, 2019; Longo et al, 2008), along with academic research (Cantrell et al, 2005; Cantrell & Brown, 2006; Lutfi et al, 2019; Mariana et al, 2019; Mustafa et al, 2021). A single systematic review was found.…”

A Decade Later—Progress and Next Steps for Pediatric Simulation Research

“…[44][45][46][47][48][49][50][51] This work identified common gaps in care that have subsequently served as the foundation for a series of projects that have resulted in improvements in structure and process measures. 10,50,[52][53][54] Most recently, the team has examined the translation of these improvements to changes in patient outcomes. Over the past 8 years, the ImPACTS has received more than 2.5 million in funding and engaged 40 tertiary care simulation teams working with more than 250 community partners.…”

“…The groups work initially focused on using mixed methods to describe, measure, and compare pediatric acute care using in situ simulations for conditions, including sepsis, cardiac arrest, Diabetic Ketoacidosis, and seizures 44–51 . This work identified common gaps in care that have subsequently served as the foundation for a series of projects that have resulted in improvements in structure and process measures 10,50,52–54 . Most recently, the team has examined the translation of these improvements to changes in patient outcomes.…”