Incorporating Interprofessional Evidenced-Based Sepsis Simulation Education for Certified Nursing Assistants (CNAs) and Licensed Care Providers Within Long-term Care Settings for Process and Quality Improvement

Abstract

Improving resident safety and quality of care by maximizing interdisciplinary communication among long-term care providers is essential in meeting the goals of the United States' Federal Health care reform. The new Triple Aim goals focus on improved patient outcomes, increasing patient satisfaction, and decreased health care costs, thus providing consumers with quality, efficient patient-focused care. Within the United States, sepsis is the 10th leading cause of death with a 28.6% mortality rate in the elderly, increasing to 40% to 60% in septic shock. As a result of the Affordable Care Act, the Centers for Medicare & Medicaid services supported the Interventions to Reduce Acute Care Transfers 3.0 program to improve health care quality and prevent avoidable rehospitalization by improving assessment, documentation, and communication among health care providers. The Interventions to Reduce Acute Care Transfers 3.0 tools were incorporated in interprofessional sepsis simulations throughout 19 long-term care facilities to encourage the early recognition of sepsis symptoms and prompt communication of sepsis symptoms among interdisciplinary teams. As a result of this simulation training, many long-term care organizations have adopted the STOP and WATCH and SBAR tools as a venue to communicate resident condition changes.

Sepsis and Clinical Simulation: What Is New? (and Old)

“…Outside the hospital, and for less skilled and less experienced healthcare workers, simulation is of considerable benefit in managing rare events and identifying sepsis-related problems [113].…”

“…Beyond recreating complex scenarios in intensive care units, simulation can be applied at all points of care of the septic patient. From diagnosis in long-term care homes [113], admission to the emergency department, passage through intermediate care units [114], the hospital ward [115], or the operating theatre [109], clinical simulation can replicate the situations in which patient care takes place. The development of in situ simulation enables training in complex settings where the early diagnosis and treatment of sepsis is critical, such as emergency departments [16] and rural hospitals and health services [115,116].…”