The clock is ticking: using in situ simulation to improve time to blood administration for bleeding trauma patients

Gray, Alice; Chartier, Lucas B.; Pavenski, Katerina; McGowan, Melissa; Lebovic, Gerald; Petrosoniak, Andrew

doi:10.1007/s43678-020-00011-9

Cited by 6 publications

(6 citation statements)

References 28 publications

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“…Another more recent study showed direct patient outcome improvement. 42 The authors showed that a novel ISS-based quality improvement (QI) intervention for blood component administration in bleeding trauma patients led to a 21% mean reduction in time between massive haemorrhage protocol activation and blood component administration. The impact of changing the institution’s massive haemorrhage protocol after the identification of LSTs during ISS was explored in this study using a pre/post design.…”

Section: Resultsmentioning

confidence: 99%

“…2 55-57 We observed that even though the included studies were quite recent, as ISS seems to have emerged in the last 20 years, the vast majority used observational prospective designs. With ISS, the proximity between the intervention and the possible patient-centred outcomes is inspiring and educators should seek collaboration with methodologists to elaborate research protocols leaning Kirkpatrick level n (%) References KP4: patient outcome 22 Abulebda et al 29 Aljahany et al 76 Barni et al 112 Chan et al 31 Couto et al 36 Geis et al 72 Gray et al 42 Hamman et al 59 Hamman et al 60 Hargestam et al 61 Kerner RL et al 62 Kobayashi et al 63 Lavelle et al 113 Paltved et al 32 Patterson et al 10 Shah et al 37 Shrestha et al 34 Steinemann et al 40 Wang et al 114 Whitfill et al 69 Petrosoniak et al 75 Theilen et al 41 Walsh et al 68 KP5: costs 2 Theilen et al 41 Petrosoniak et al 75 Other, NA 10 Hunt et al 44 Kobayashi et al 52 Mondrup et al 33 Kessler et al 115 Siegel et al 43 Stevens et al 116 Wieck et al 117 Nadkarni et al 118 Auerbach et al 119 O'Leary et al 87 NA, not available.…”

Section: Study Methodology Limitationsmentioning

confidence: 99%

“…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%

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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: Resultsmentioning

confidence: 99%

Section: Study Methodology Limitationsmentioning

confidence: 99%

Section: Satefy-related Parameters N (%) Referencesmentioning

confidence: 99%

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

Truchot

Boucher

et al. 2022

BMJ Open

Self Cite

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“…In addition, outcomes such as improvement of non-practical skills and human factors are difficult to evaluate and may be underreported [ 55 , 56 ]. Examples from the adult and pediatric literature show that simulation-based education has led to improvement in certain patient outcomes such as a decrease in “time to needle” in stroke patients [ 57 ], a decrease in time to blood transfusion in trauma patients [ 58 ], improved clinical response to postpartum hemorrhage [ 59 ], and increased survival to discharge after cardiac arrest [ 60 ].…”

Section: Simulation and Patient Outcomesmentioning

confidence: 99%

Simulation in neonatal care: towards a change in traditional training?

2022

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Simulation has traditionally been used in neonatal medicine for educational purposes which include training of novice learners, maintaining competency of health care providers, and training of multidisciplinary teams to handle crisis situations such as neonatal resuscitation. Current guidelines recommend the use of simulation as an education tool in neonatal practice. The place of simulation-based education has gradually expanded, including in limited resource settings, and is starting to show its impact on improving patient outcomes on a global basis. Over the past years, simulation has become a cornerstone in clinical settings with the goal of establishing high quality, safe, reliable systems. The aim of this review is to describe neonatal simulation training as an effective tool to improve quality of care and patient outcomes, and to encourage the use of simulation-based training in the neonatal intensive care unit (NICU) for not only education, but equally for team building, risk management and quality improvement. Conclusion : Simulation is a promising tool to improve patient safety, team performance, and ultimately patient outcomes, but scarcity of data on clinically relevant outcomes makes it difficult to estimate its real impact. The integration of simulation into the clinical reality with a goal of establishing high quality, safe, reliable, and robust systems to improve patient safety and patient outcomes in neonatology must be a priority. What is Known: • Simulation-based education has traditionally focused on procedural and technical skills. • Simulation-based training is effective in teaching non-technical skills such as communication, leadership, and teamwork, and is recommended in neonatal resuscitation . What is New: • There is emerging evidence for the impact of simulation-based training on patient outcomes in neonatal care, but data on clinically relevant outcomes are scarce. • Simulation is a promising tool for establishing high quality, safe, reliable, and robust systems to improve patient safety and patient outcomes.

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“…One study showed that a simulation program developed from the findings of a process improvement analysis provided a sustainable improvement in the time until massive transfusion at an adult trauma center. 73 Although the time benefit of the intervention was small (about 2 minutes), this study highlights how process analyses can be translated into clinical change. Finally, given the potential contribution of uncertainty to delays, pediatric tools for predicting hemorrhage early after injury need to be moved from the development phase to the bedside.…”

Section: Future Directionsmentioning

confidence: 87%

Time is tissue: Barriers to timely transfusion after pediatric injury

Sullivan

Gestrich-Thompson

Milestone

et al. 2022

J Trauma Acute Care Surg

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Strategies to improve outcomes among children and adolescents in hemorrhagic shock have primarily focused on component resuscitation, pharmaceutical coagulation adjuncts, and hemorrhage control techniques. Many of these strategies have been associated with better outcomes in children, but the barriers to their use and the impact of timely use on morbidity and mortality have received little attention. Because transfusion is uncommon in injured children, few studies have identified and described barriers to the processes of using these interventions in bleeding patients, processes that move from the decision to transfuse, to obtaining the necessary blood products and adjuncts, and to delivering them to the patient. In this review, we identify and describe the steps needed to ensure timely blood transfusion and propose practices to minimize barriers in this process. Given the potential impact of time on hemorrhage associated outcomes, ensuring timely intervention may have a similar or greater impact than the interventions themselves.

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The clock is ticking: using in situ simulation to improve time to blood administration for bleeding trauma patients

Cited by 6 publications

References 28 publications

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

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

Simulation in neonatal care: towards a change in traditional training?

Time is tissue: Barriers to timely transfusion after pediatric injury

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