Simulation for Clinical Preparedness in Pediatric Emergencies

Abstract

Positive outcomes for pediatric in-hospital cardiopulmonary arrest remain low with little change in mortality rates. Infrequently used clinical knowledge and skills decline quickly, contributing to poor quality of resuscitation. The aim of this pilot study exploring the outcomes of repeated pediatric mock code simulations with structured debriefing demonstrated statistically significant differences in participants’ knowledge of pediatric emergencies, with no significant decline in resuscitation skills. This provides an evidence-based approach for professional development educators working with nurses on pediatric emergencies.

What can be learned from the literature about intervals and strategies for paediatric CPR retraining of healthcare professionals? A scoping review of literature

“… Retention: at 12-month follow up, group 1 improved significantly compared to group 2 for proportion of excellent CPR: (19.5% vs 71.7%, p < 0.001). Distributed short practice model with RTF improves the quality of CPR and the long-term skill retention Mariani et al 47 (2019), USA Pre- and post-test, 18 paediatric nurses, hospital Control group: baseline knowledge assessment + self-confidence survey; mock code at 9-months; knowledge assessment and self-confidence survey at 11-months; Intervention group: baseline knowledge assessment and self-confidence survey; simulation with debriefing at months 1, 5 and 9; knowledge assessment and self-confidence survey at month 11. knowledge, skills, self-confidence No statistically significant difference between groups at baseline; Statistically significant difference in the post-test scores (p = 0.016) with the intervention group scoring higher than the control group.…”

“…The geographical areas consisted of Thailand, 33 USA, 22 , 28 , 34 , 35 , 36 , 37 , 38 , 40 , 41 , 43 , 44 , 47 , 51 Japan/USA, 45 UK, 39 Canada, 42 , 46 , 49 Australia 48 and Norway. 50 The methodology varied significantly and included pre/post-test, 33 , 36 , 40 , 47 , 51 mixed-methods, 34 interventional studies, 35 , 37 RCTs 28 , 38 , 39 , 44 , 45 , 46 , 49 , 50 and observational studies. 22 , 41 , 42 , 43 , 48 …”

“…Different training strategies were observed, with the majority of studies using PALS or BLS as initial training models. Most of the interventions (14) were team-based training 33 , 34 , 35 , 36 , 40 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 but of those, 12 studies included cognitive and/or psychomotor skill practice on individual level. 33 , 34 , 35 , 36 , 40 , 43 , 44 , 45 , 46 , 47 , 49 , 50 Interventions included the traditional instructor-based training; 28 , 33 , 45 , 49 simulation-based mock code program; 34 , 47 , 51 simulation only; 38 simulation with debriefing; 35 , 44 , 48 high-fidelity simulation; 47 feedback of performance; 33 , 43 refresher sessions; 22 , 41 training with real-time feedback; 28 , 37 , 39 , 40 , 41 , 42 , 50 and distributed practice.…”

“…Most of the interventions (14) were team-based training 33 , 34 , 35 , 36 , 40 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 but of those, 12 studies included cognitive and/or psychomotor skill practice on individual level. 33 , 34 , 35 , 36 , 40 , 43 , 44 , 45 , 46 , 47 , 49 , 50 Interventions included the traditional instructor-based training; 28 , 33 , 45 , 49 simulation-based mock code program; 34 , 47 , 51 simulation only; 38 simulation with debriefing; 35 , 44 , 48 high-fidelity simulation; 47 feedback of performance; 33 , 43 refresher sessions; 22 , 41 training with real-time feedback; 28 , 37 , 39 , 40 , 41 , 42 , 50 and distributed practice. 44 , 45 , 46 , 49 As some studies used distributed practice as part of their learning strategies prior to retraining interventions, 44 , 45 , 46 , 49 the authors highlighted these studies in the results table ( Table 1 ), as the concept of distributed practice may have a positive effect on performance and retention of skills.…”

Consenso Latinoamericano de Reanimación Cardiopulmonar

“…El informe «Errar es humano» (To err is Human) concluyó que el 70% de los eventos adversos se deben al factor humano, habilidades no técnicas o «blandas», recomendando entrenamiento interdisciplinario de los equipos en gestión de situaciones de alto riesgo 258 . El programa de Gestión de Recursos de Tripulación/Cabina (Crew/Cockpit Resource Management [CRM]) en comunicación eficiente, conciencia situacional, resolución de problemas, toma de decisiones y trabajo en equipo para la aviación 259 , fue posteriormente adaptado al campo de la salud, para mejorar el trabajo en equipo y reducir los errores 260 267,268 ) sobre el desarrollo de este, análisis del «porqué» de las acciones, entendimiento del modelo mental y propuestas de mejora 265 . La simulación debe procurar fidelidad física (escenario), emocional (sentimientos del entrenando al ingresar al escenario) y conceptual (nivel de recreación de la situación clínica real) 269 .…”