&lt;p&gt;COVID-19 Emergency Department Protocols: Experience of Protocol Implementation Through in-situ Simulation&lt;/p&gt;

Shrestha, Anmol Purna; Shrestha, Abha; Sonnenberg, Taylor; Shrestha, Ranjana

doi:10.2147/oaem.s266702

Cited by 16 publications

(14 citation statements)

References 23 publications

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“…LST evaluation 24 (25) Chan et al 31 Hamman et al 59 Hamman et al 60 Hunt et al 44 Kerner et al 62 Kobayashi et al 52 Kobayashi et al 63 O'Leary et al 64 Patterson et al 10 Shrestha et al 34 Theilen et al 41 Ullman et al 67 Walsh et al 68 Whitfill et al 69 Zimmermann et al 70 Bradley et al 71 Couto et al 36 Geis et al 72 Lakissian et al 73 Shah et al 37 Wong et al 74 Petrosoniak et al 75 Aljahany et al 76 Zern et al 77 Shrestha et al 78 Gray et al 42 Others (survey, qualitative analysis) Bischof et al 80 Burke et al 81 Couto et al 13 Davison et al 82 Gangadharan et al 83 Gundrosen et al 84 Hunt et al 44 Mannenbach et al 85 Meurling et al 86 O'Leary et al 87 Shrestha et al 34 Sørensen et al 88 Ullman et al 67 Katznelson et al 89 KP 2: knowledge and skills 10 Walsh et al 68 Bradley et al 71 Thomas et al 90 Lemke et al 91 Kalidindi et al…”

Section: Satefy-related Parameters N (%) Referencesmentioning

confidence: 99%

Is in situ simulation in emergency medicine safe? A scoping review

Truchot

Boucher

et al. 2022

BMJ Open

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ObjectivesTo provide an overview of the available evidence regarding the safety of in situ simulation (ISS) in the emergency department (ED).DesignScoping review.MethodsOriginal articles published before March 2021 were included if they investigated the use of ISS in the field of emergency medicine.Information sourcesMEDLINE, EMBASE, Cochrane and Web of Science.ResultsA total of 4077 records were identified by our search strategy and 2476 abstracts were screened. One hundred and thirty full articles were reviewed and 81 full articles were included. Only 33 studies (40%) assessed safety-related issues, among which 11 chose a safety-related primary outcome. Latent safety threats (LSTs) assessment was conducted in 24 studies (30%) and the cancellation rate was described in 9 studies (11%). The possible negative impact of ISS on real ED patients was assessed in two studies (2.5%), through a questionnaire and not through patient outcomes.ConclusionMost studies use ISS for systems-based or education-based applications. Patient safety during ISS is often evaluated in the context of identifying or mitigating LSTs and rarely on the potential impact and risks to patients simultaneously receiving care in the ED. Our scoping review identified knowledge gaps related to the safe conduct of ISS in the ED, which may warrant further investigation.

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Section: Satefy-related Parameters N (%) Referencesmentioning

confidence: 99%

Is in situ simulation in emergency medicine safe? A scoping review

Truchot

Boucher

et al. 2022

BMJ Open

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“…Our study represents a novel attempt to describe the experiences of healthcare professionals tasked with adjusting to a rapidly disseminated protocol during the COVID-19 pandemic. These results contribute to a small but growing body of literature comprising previous studies describing the implementation, operation, safety, and efficacy of emergency response intubation teams [ 3 – 5 , 33 – 35 ]. Our findings highlight the need for evaluating the subjective experience of healthcare providers when transitioning to new models of care in response to emergencies.…”

Section: Discussionmentioning

confidence: 64%

Experiences of healthcare providers with a novel emergency response intubation team during COVID-19

et al. 2022

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Objectives In the early stages of the COVID-19 pandemic, there were significant concerns about the infectious risks of intubation to healthcare providers. In response, a dedicated emergency response intubation team (ERIT) consisting of anesthesiologists and allied health providers was instituted for our emergency department (ED). Given the high-risk nature of intubations and the new interprofessional team dynamics, we sought to assess health-care provider experiences and potential areas of improvement. Methods Surveys were distributed to healthcare providers at the University Health Network, a quaternary healthcare centre in Toronto, Canada, which includes two urban EDs seeing over 128,000 patients per year. Participants included ED physicians and nurses, anesthesiologists, anesthesia assistants, and operating room nurses. The survey included free-text questions. Responses underwent thematic analysis using grounded theory and were independently coded by two authors to generate descriptive themes. Discrepancies were resolved with a third author. Descriptive themes were distilled through an inductive, iterative process until fewer main themes emerged. Results A total of 178 surveys were collected (68.2% response rate). Of these, 123 (69%) participated in one or more ERIT activations. Positive aspects included increased numbers of staff to assist, increased intubation expertise, improved safety, and good team dynamics within the ERIT team. Challenges included a loss of scope (primarily ED physicians and nurses) and unfamiliar workflows, perceived delays to ERIT team arrival or patient intubation, role confusion, handover concerns, and communication challenges between ED and ERIT teams. Perceived opportunities for improvement included interprofessional training, developing clear guidelines on activation, inter-team role clarification, and guidelines on handover processes post-intubation. Conclusions Healthcare providers perceived that a novel interprofessional collaboration for intubations of COVID-19 patients presented both benefits and challenges. Opportunities for improvement centred around interprofessional training, shared decision making between teams, and structured handoff processes.

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“…[4][5][6][7] Our data also corroborated studies that showed that simulation was essential for developing, testing, refining and implementing new workflows and protocols in healthcare. 8,10,11,18,19 This was also essential in the context of the COVID-19 pandemic, in which we trained healthcare professionals on the new protocol for safe and effective care of patients with COVID-19.…”

Section: Discussionmentioning

confidence: 99%

“…In situ simulation is a fast and efficient way for training a multidisciplinary team because training takes place during the team's hours of service, using the workplace resources. 19 In this study, we decided to use questions with very short answers. Use of questions of this nature made it possible to assess the participants' knowledge without giving any clues about the correct answer.…”

Section: Discussionmentioning

confidence: 99%

Implementing healthcare professionals’ training during COVID-19: a pre and post-test design for simulation training

Santos¹,

Pedrosa²,

Carvalho³

et al. 2021

Sao Paulo Med. J.

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Coronavirus disease-19 has imposed a new reality through the pandemic that it has caused, and this presents challenges to healthcare professionals and systems. The high rate of transmissibility of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), through droplets, aerosols and contaminated surfaces, has led to development of strict protocols for individual and collective protection for patient care, 1,2 which have been implemented throughout hospitals. Adaptations to protocols for procedures have been brought in, including use of alternative medications to minimize virus transmission in aerosol-producing procedures, donning and doffing of personal protective equipment (PPE) and other measures.The implementation of these new protocols has required training for all front-line healthcare workers, without endangering them or their patients. Use of simulations may be an appropriate way for providing training since this replicates real-environment situations in a safe environment, and thus protects both patients and professionals from unnecessary risks. Simulation training has been widely used for continuing professional development, in order to train healthcare professionals in relation to new systems, thereby enabling them to remain up-to-date regarding new demands and protocols within their clinical practice. [3][4][5][6][7] Simulation has played a key role in testing and implementing new workflow structures, new protocols and cognitive resources, 8 through offering participants the possibility to practice rare and critical events in a controlled environment. 9In the current pandemic, simulation has been shown to be useful for testing healthcare systems, processes and new protocols. [10][11][12][13][14][15] Moreover, studies have shown that simulation is an appropriate teaching tool that has the capacity to quickly prepare frontline teams for changes that are necessary, through generating gains in knowledge and skills. 10,13,16,17

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<p>COVID-19 Emergency Department Protocols: Experience of Protocol Implementation Through in-situ Simulation</p>

Cited by 16 publications

References 23 publications

Is in situ simulation in emergency medicine safe? A scoping review

Is in situ simulation in emergency medicine safe? A scoping review

Experiences of healthcare providers with a novel emergency response intubation team during COVID-19

Implementing healthcare professionals’ training during COVID-19: a pre and post-test design for simulation training

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