Multiprofessional in situ simulation is an effective method of identifying latent patient safety threats on the gastroenterology ward

Uttley, Elizabeth; Suggitt, Deborah; Baxter, David; Jafar, Wisam

doi:10.1136/flgastro-2019-101307

Cited by 10 publications

(13 citation statements)

References 30 publications

(56 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 15 Our simulation team demonstrated that ward-based ISS was a powerful tool to identify latent errors in education/training, equipment, medication and teamworking on a gastroenterology ward during simulated medical emergencies. 12 We also showed that ISS was well perceived by healthcare staff and positively impacted on participant confidence and role recognition.…”

Section: Introductionmentioning

confidence: 63%

Ward-based in situ simulation: lessons learnt from a UK District General Hospital

Schwartze,

Das,

Suggitt

et al. 2024

BMJ Open Qual

Self Cite

View full text Add to dashboard Cite

IntroductionIn situ simulation (ISS) enables multiprofessional healthcare teams to train for real emergencies in their own working environment and identify latent patient safety threats. This study aimed to determine ISS impact on teamwork, technical skill performance, healthcare staff perception and latent error identification during simulated medical emergencies.Materials and methodsUnannounced ISS sessions (n=14, n=75 staff members) using a high-fidelity mannequin were conducted in medical, paediatric and rehabilitation wards at Stepping Hill Hospital (Stockport National Health Service Foundation Trust, UK). Each session encompassed a 15 min simulation followed by a 15 min faculty-led debrief.ResultsThe clinical team score revealed low overall teamwork performances during simulated medical emergencies (mean±SEM: 4.3±0.5). Linear regression analysis revealed that overall communication (r=0.9, p<0.001), decision-making (r=0.77, p<0.001) and overall situational awareness (r=0.73, p=0.003) were the strongest statistically significant predictors of overall teamwork performance. Neither the number of attending healthcare professionals, their professional background, age, gender, degree of clinical experience, level of resuscitation training or previous simulation experience statistically significantly impacted on overall teamwork performance. ISS positively impacted on healthcare staff confidence and clinical training. Identified safety threats included unknown location of intraosseous kits, poor/absent airway management, incomplete A–E assessments, inability to activate the major haemorrhage protocol, unknown location/dose of epinephrine for anaphylaxis management, delayed administration of epinephrine and delayed/absence of attachment of pads to the defibrillator as well as absence of accessing ALS algorithms, poor chest compressions and passive behaviour during simulated cardiac arrests.ConclusionPoor demonstration of technical/non-technical skills mandate regular ISS interventions for healthcare professionals of all levels. ISS positively impacts on staff confidence and training and drives identification of latent errors enabling improvements in workplace systems and resources.

show abstract

Section: Introductionmentioning

confidence: 63%

Ward-based in situ simulation: lessons learnt from a UK District General Hospital

Schwartze,

Das,

Suggitt

et al. 2024

BMJ Open Qual

Self Cite

View full text Add to dashboard Cite

show abstract

“…An assessor-blinded RCT by the same group found that novice trainees exposed to a comprehensive non-technical skills curriculum (covering didactic teaching and case base scenario, virtual reality (VR) simulation, scenario training and specific non-technical skills feedback) demonstrated superior overall performance and ENTS ratings in their hands-on cases compared with the control group 63. Additionally, didactic teaching and multiprofessional in situ simulation training can be used to improve ENTS 12 64 65…”

Section: Recommendation Statementsmentioning

confidence: 99%

JAG consensus statements for training and certification in flexible sigmoidoscopy

Siau

Pelitari

Green

et al. 2023

Frontline Gastroenterol

View full text Add to dashboard Cite

IntroductionJoint Advisory Group (JAG) certification in endoscopy is awarded when trainees attain minimum competency standards for independent practice. A national evidence-based review was undertaken to update standards for training and certification in flexible sigmoidoscopy (FS).MethodsA modified Delphi process was conducted between 2019 and 2020 with multisociety representation from experts and trainees. Following literature review and Grading of Recommendations, Assessment, Development and Evaluations appraisal, recommendation statements on FS training and certification were formulated and subjected to anonymous voting to obtain consensus. Accepted statements were peer-reviewed by national stakeholders for incorporation into the JAG FS certification pathway.ResultsIn total, 41 recommendation statements were generated under the domains of: definition of competence (13), acquisition of competence (17), assessment of competence (7) and postcertification support (4). The consensus process led to revised criteria for colonoscopy certification, comprising: (A) achieving key performance indicators defined within British Society of Gastroenterology standards (ie, rectal retroversion >90%, polyp retrieval rate >90%, patient comfort <10% with moderate-severe discomfort); (B) minimum procedure count ≥175; (C) performing 15+ procedures over the preceding 3 months; (D) attendance of the JAG Basic Skills in Lower gastrointestinal Endoscopy course; (E) satisfying requirements for formative direct observation of procedural skill (DOPS) and direct observation of polypectomy skill (SMSA level 1); (F) evidence of reflective practice as documented on the JAG Endoscopy Training System reflection tool and (G) successful performance in summative DOPS.ConclusionThe UK standards for training and certification in FS have been updated to support training, uphold standards in FS and polypectomy, and provide support to the newly independent practitioner.

show abstract

“…More recently, an assessor-blinded RCT by the same group found that novice trainees exposed to a comprehensive non-technical skills curriculum (covering didactic teaching and case base scenario, virtual reality (VR) simulation, scenario training and specific non-technical skills feedback) had superior overall colonoscopy performance and non-technical skills ratings in their hands-on cases compared with the control group 67. Additionally, didactic teaching and multiprofessional in situ simulation training can be used to improve ENTS 17 68 69…”

Section: Recommendation Statementsmentioning

confidence: 99%

JAG consensus statements for training and certification in colonoscopy

Siau

Pelitari

Green

et al. 2023

Frontline Gastroenterol

View full text Add to dashboard Cite

IntroductionIn the UK, endoscopy certification is awarded when trainees attain minimum competency standards for independent practice. A national evidence-based review was undertaken to update and develop standards and recommendations for colonoscopy training and certification.MethodsUnder the oversight of the Joint Advisory Group (JAG), a modified Delphi process was conducted between 2019 and 2020 with multisociety expert representation. Following literature review and Grading of Recommendations, Assessment, Development and Evaluations appraisal, recommendation statements on colonoscopy training and certification were formulated and subjected to anonymous voting to obtain consensus. Accepted statements were peer reviewed by JAG and relevant stakeholders for incorporation into the updated colonoscopy certification pathway.ResultsIn total, 45 recommendation statements were generated under the domains of: definition of competence (13), acquisition of competence (20), assessment of competence (8) and postcertification support (4). The consensus process led to revised criteria for colonoscopy certification, comprising: (1) achieving key performance indicators defined within British Society of Gastroenterology standards (ie, unassisted caecal intubation rate >90%, rectal retroversion >90%, polyp detection rate >15%+, polyp retrieval rate >90%, patient comfort <10% with moderate–severe discomfort); (2) minimum procedure count 280+; (3) performing 15+ procedures over the preceding 3 months; (4) attendance of the JAG Basic Skills in Colonoscopy course; (5) terminal ileal intubation rates of 60%+ in inflammatory bowel disease; (6) satisfying requirements for formative direct observation of procedure skills (DOPS) and direct observation of polypectomy skills (Size, Morphology, Site, Access (SMSA) level 2); (7) evidence of reflective practice as documented on the JAG Endoscopy Training System reflection tool; (8) successful performance in summative DOPS.ConclusionThe UK standards for training and certification in colonoscopy have been updated, culminating in a single-stage certification process with emphasis on polypectomy competency (SMSA Level 2+). These standards are intended to support training, improve standards of colonoscopy and polypectomy, and provide support to the newly independent practitioner.

show abstract

Multiprofessional in situ simulation is an effective method of identifying latent patient safety threats on the gastroenterology ward

Cited by 10 publications

References 30 publications

Ward-based in situ simulation: lessons learnt from a UK District General Hospital

Ward-based in situ simulation: lessons learnt from a UK District General Hospital

JAG consensus statements for training and certification in flexible sigmoidoscopy

JAG consensus statements for training and certification in colonoscopy

Contact Info

Product

Resources

About