In Situ Simulated Cardiac Arrest Exercises to Detect System Vulnerabilities

Barbeito, Atílio; Bonifacio, Alberto S.; Holtschneider, Mary Edel; Segall, Noa; Schroeder, Rebecca; Mark, Jonathan B.

doi:10.1097/sih.0000000000000087

Cited by 38 publications

(40 citation statements)

References 2 publications

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“…Two studies developed training programs to simulate crises that would trigger the response of hospital-wide ad hoc resuscitation teams/code teams to an inpatient unit. 29 30 One study simulated a pediatric cardiopulmonary arrest (CPA), 29 and the other study simulated an adult CPA. 30 A summary of simulations in this setting is provided in Table 5 .…”

Section: Resultsmentioning

confidence: 99%

The Role of High-Fidelity Team-Based Simulation in Acute Care Settings: A Systematic Review

Armenia

Thangamathesvaran

Caine

et al. 2018

Surg J

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Introduction High-fidelity team-based simulation has been identified as an effective way of teaching and evaluating both technical and nontechnical skills. Several studies have described the benefits of this modality in a variety of acute care settings, but a lack of standardized methodologies has resulted in heterogeneous findings. Few studies have characterized high fidelity simulation across a broad range of acute care settings and integrated the latest evidence on its educational and patient impact. Methods The MEDLINE, EMBASE, Cochrane Library, and PsycINFO databases were searched for empirical studies from the last 10 years, investigating high fidelity team-based simulation in surgical, trauma, and critical care training curricula. Results Seventeen studies were included. Interventions and evaluations were comprehensively characterized for each study and were discussed in the context of four overarching acute care settings: the emergency department/trauma bay, the operating room, the intensive care unit, and inpatient ad hoc resuscitation teams. Conclusions The use of high-fidelity team-based simulation has expanded in acute care and is feasible and effective in a wide variety of specialized acute settings, including the emergency department/trauma bay, the operating room, the intensive care unit, and inpatient ad hoc resuscitation teams. Training programs have evolved to emphasize team-based, multidisciplinary education models and are often conducted in situ to maximize authenticity. In situ simulations have also provided the opportunity for system-level improvement and discussions of complex topics such as social hierarchy. There is limited evidence supporting the impact of simulation on patient outcomes, sustainability of simulation efforts, or cost-effectiveness of training programs. These areas warrant further research now that the scope of utilization across acute care settings has been characterized.

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Section: Resultsmentioning

confidence: 99%

The Role of High-Fidelity Team-Based Simulation in Acute Care Settings: A Systematic Review

Armenia

Thangamathesvaran

Caine

et al. 2018

Surg J

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“…Categorical data were summarised using percentages. Individual responses to each data item were coded on a continuous scale from not at all realistic 1 to realistic 9 and were recoded to categories of not realistic (score 1-3), intermediate (score [4][5][6] or realistic (score 7-8). Responses of 'not applicable' were omitted from the analyses.…”

Section: Statistical Methods and Sample Size Estimationmentioning

confidence: 99%

“…[3][4][5][6][7][8] Simulation training can also be used as a tool to identify latent errors within hospital systems and as part of a participant or team assessment process. [9][10][11][12][13][14][15] The majority of simulations occur either in a purpose built centre or in the real clinical environment (in situ). A recent paper by Couto et al 16 summarises the differences between the two environments and these are described in Table 1.…”

Section: Introductionmentioning

confidence: 99%

Realism in paediatric emergency simulations: A prospective comparison of in situ, low fidelity and centre‐based, high fidelity scenarios

O’Leary

Pegiazoglou

McGarvey

et al. 2017

Emerg Medicine Australasia

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Objective: To measure scenario participant and faculty self-reported realism, engagement and learning for the low fidelity, in situ simulations and compare this to high fidelity, centre-based simulations. Methods: A prospective survey of scenario participants and faculty completing in situ and centre-based paediatric simulations.Results: There were 382 responses, 276 from scenario participants and 106 from faculty with 241 responses from in situ and 141 from centre-based simulations. Scenario participant responses showed significantly higher ratings for the centre-based simulations for respiratory rate (P = 0.007), pulse (P = 0.036), breath sounds (P = 0.002), heart sounds (P < 0.001) and patient noises (P < 0.001). There was a significant difference in overall rating of the scenario reality by scenario participants in favour of the centre-based simulations (P = 0.005); however, there was no significant difference when rating participant engagement (P = 0.11) and participant learning (P = 0.77). With the centre-based scenarios, nurses rated the reality of the respiratory rate (P < 0.001), blood pressure (P = 0.016) and abdominal signs (P = 0.003) significantly higher than doctors. Nurses rated the overall reality higher than doctors for the centre simulations (96.8% vs 84.2% rated as realistic, P = 0.041), which was not demonstrated in the in situ scenarios (76.2% vs 73.5%, P = 0.65). Conclusion: Some aspects of in situ simulations may be less 'real' than centre-based simulations, but there was no significant difference in selfreported engagement or learning by scenario participants. Low fidelity, in situ simulation provides adequate realism for engagement and learning.

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“…A simulação no ambiente de trabalho real foi identificada como particularmente valiosa, porque reúne os elementos da equipe de atendimento e do ambiente (12) . Pesquisadores reconheceram que o papel da simulação in situ vai além do treinamento e da avaliação de habilidades técnicas e não técnicas, sobretudo, enfatizaram as maneiras exclusivas pelas quais essa estratégia poderia ser usada para avaliar a competência do sistema e identificar condições latentes que predispõem ao erro médico (11) .…”

Section: Introductionunclassified

Simulação in situ: ganho da autoconfiança de profissionais de enfermagem na parada cardiopulmonar

2019

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Objetivo: comparar a simulação in situ em relação à aula didática tradicional, no ganho da autoconfiança de profissionais da equipe de enfermagem, em situação de parada cardiopulmonar. Métodos: estudo quasi-experimental, não equivalente, desenvolvido em unidade de terapia intensiva e pronto socorro de hospital geral. A intervenção foi a simulação in situ. Para coleta de dados, adotou-se questionário de caracterização profissional, a autoconfiança avaliada pela escala Self-Confidence Scale. Considerou-se significativo resultados com p≤0,050. Resultados: participaram 37 profissionais de enfermagem. O grupo experimental pré-simulação se mostrou menos autoconfiante (3,4±0,6) quando comparado ao grupo controle (3,9±0,7). Entretanto, 30 dias após a intervenção, o grupo experimental mostrou a manutenção de ganho significativo da confiança (p=0,040). Conclusão: a autoconfiança dos profissionais de enfermagem, direcionada à assistência ao paciente em parada cardiopulmonar, melhorou significativamente com emprego da simulação in situ, quando comparada à aula didática tradicional, dialogada.

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In Situ Simulated Cardiac Arrest Exercises to Detect System Vulnerabilities

Abstract: We describe an ongoing program that uses in situ simulation to identify and mitigate latent hazards and defects in the hospital emergency response system. The SEIPS model provides a framework for describing and analyzing the structure, processes, and outcomes related to these events.

Cited by 38 publications

References 2 publications

The Role of High-Fidelity Team-Based Simulation in Acute Care Settings: A Systematic Review

The Role of High-Fidelity Team-Based Simulation in Acute Care Settings: A Systematic Review

Realism in paediatric emergency simulations: A prospective comparison of in situ, low fidelity and centre‐based, high fidelity scenarios

Simulação in situ: ganho da autoconfiança de profissionais de enfermagem na parada cardiopulmonar

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