In-situ simulation-based intervention for enhancing teamwork in the emergency department

Abstract

Simulation-based learning activities in the emergency department (ED) improve communication and teamwork and familiarise personnel with existing protocols. The authors’ objective was to develop standardised in-situ simulations and to assess their effects on team performance during simulated patient care. The study was a prospective, single-centre pre-in-situ and post-in-situ simulation-based intervention in the ED of an academic hospital between March 2017 and February 2018. Teams of three to five participants (n=46) were in two simulation interventions 2 weeks apart; each simulation was followed by debriefing with good judgement. The adapted Simulation Team Assessment Tool (STAT) Score was the primary measure for team performance. Skills are measured on a scale of 2–0 based on the complete and timely performance of tasks for a total (adapted) score of 171. Overall STAT scores improved significantly between simulations I (60.5 (28.3)) and II (81.1 (24.6)), p=029; notably in airway and teamwork domains, p=022 and p=023, respectively. A sub-analysis showed that participants performed significantly better when treating adult versus paediatric simulated patients (87.9 (20.1)), p=003, particularly in teamwork, p=01. The study yielded statistically significant improvement in clinical management, teamwork and resource management skills among ED personnel.

The Biological Signal Visualization Algorithm for Heart Surgery Simulator

“…A user can operate the signal display in the browser, and you can check the waveform for the data by selecting the desired data from a biometric database for different diseases and situations. In extracted data source files, a screen-based on patientsensitive monitors are constructed using a browser or server through HTML, JAVASCRIPT, and CSS, as shown in the picture below [8]. In addition, for emergencies and emergencies that can occur in a real surgical environment, patterns through pulse rate/blood pressure changes were implemented when certain values were entered.…”

In situ simulation and its different applications in healthcare: an integrative review

“…Training programs for multidisciplinary teams 4,11,12,22,32,39,[53][54][55][56]95,106,107 using ISS have been shown to effectively improve the technical and non-technical skills of health professionals for managing emergency situations, in addition to optimize learning, both at individual's and team's levels 90 . Thus, ISS can be valuable to improve patient safety, as it allows the practice of care team dynamics within a real clinical environment 4 .…”

“…National studies have shown that professionals perceived the in situ simulation strategy as valid for professional updating and practical learning in a safe environment [5][6][7][8] . At the international level, it can be observed that simulation is widely practiced at different levels of care 9,10 , also as a quick and efficient tool to implement protocols in cases of outbreaks [11][12][13][14][15][16] and can also be an acceptable approach for training the interprofessional team in primary care 17 .…”

Simulação in situ e suas diferentes aplicações na área da saúde: uma revisão integrativa

“…Diversos artigos sobre o uso da SIS para otimizar a segurança do paciente mostraram melhor clareza dos papéis dos membros da equipe em relação à administração de medicamentos feitas no ambiente clínico 95,102-104 e à capacidade de identificar ameaças de segurança latentes mitigadas pela prática 2,4,13,46,49,[64][65][66][67][68][69][70][76][77][78][79]89,95,105 . Programas de capacitações de equipes multidisciplinares 4,11,12,22,32,39,[53][54][55][56]95,106,107 com o uso de SIS demonstraram que ela melhora, efetivamente, as habilidades técnicas e não técnicas dos profissionais de saúde para o gerenciamento de situações de emergência, além de otimizar o aprendizado tanto individual quanto da equipe 90 . Assim, a SIS pode ser valiosa na melhoria da segurança do paciente, pois permite a prática da dinâmica da equipe assistencial dentro de um ambiente clínico real 4 .…”

“…Os trabalhos nacionais mostraram que os profissionais perceberam a estratégia da SIS como válida para a atualização profissional e o aprendizado prático em ambiente seguro [5][6][7][8] . No âmbito internacional, nota-se que a simulação é amplamente praticada em diversos níveis de assistência 9,10 , inclusive como uma ferramenta rápida e eficiente para implementar os protocolos em casos de surtos [11][12][13][14][15][16] , além de ser uma abordagem aceitável para a capacitação da equipe interprofissional na atenção primária 17 .…”