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Showing results for tags 'Simulation'.
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Content ArticleHealthcare simulation is an established technique for improving patient safety, through training individual skills, teamwork behaviours, and by testing healthcare systems for latent safety threats. However, healthcare simulation may present risks to safety, especially when delivered ‘in situ’—in real clinical environments—when lines between simulated and real practice may be blurred. Brazil et al. developed a simulation safety policy (SSP) after reading reports of adverse events in the healthcare simulation literature, editorials highlighting these safety risks, and reflecting on our own experience as a busy translational simulation service in a large healthcare institution. The process for development of a comprehensive SSP for translational simulation programs is unclear. Personal correspondence with leaders of simulation programs like our own revealed a piecemeal approach in most institutions. In this article, the authors describe the process we used to develop the simulation safety policy at our health service, and crystalize principles that may provide guidance to simulation programs with similar challenges.
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Content Article
Intensive Care bed space orientation
Claire Cox posted an article in Other health and care software
This interactive orientation of an Intensive Care Unit (ICU) bed space, created by the London Transformation and Learning Collaborative, is ideal for healthcare professionals new to the ICU environment. It allows you to explore the risks and demonstrated the safety check required to keep patients safe in the ICU. This application is best used with a smart phone, but can be used on a computer. -
Content ArticleIn this 30 minute video presentation, we hear from Dr Victoria Brazil, Professor of Emergency Medicine and Director of Simulation, Gold Coast Health Service. Dr Brazil talks through the benefits and complexities of simulation training using real life footage to illustrate key points. She suggests there are three ways healthcare can be improved using simulation: Simulation to explore Simulation to test Simulation to embed.
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Content ArticleThis study from Sanko et al., published in Simulation in Healthcare, found that improvements in systems thinking increase adverse event (AE) reporting patterns among undergraduate nursing students participating in a simulation exercise. The authors suggest that prelicensure training include reinforcement of systems thinking principles to achieve patient safety improvements.
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Content ArticleUser-testing and subsequent modification of clinical guidelines increases health professionals’ information retrieval and comprehension, but no study has investigated whether this results in safer care. Jones et al. compared the frequency of medication errors when administering an intravenous medicine using the current National Health Service Injectable Medicines Guide (IMG) versus an IMG version revised with user-testing. Participants were on-duty nurses/midwives who regularly prepared intravenous medicines. Using a training manikin in their clinical area, participants administered a voriconazole infusion, a high-risk medicine requiring several steps to prepare. They were randomised to use current IMG guidelines or IMG guidelines revised with user-testing.
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Content ArticleThis study, published in US journal Chest, looks at the case of a patient who experienced severe hypoglycemia due to an infusion of a higher-than-ordered insulin dose. The event could have been prevented if the insulin syringe pump was checked during the nursing shift handoff. Risk management exploration included direct observations of nursing shift handoffs, which highlighted common deficiencies in the process. This led to the development and implementation of a handoff protocol and the incorporation of handoff training into a simulation-based teamwork and communication workshop.
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Content ArticleTo address increasing patient demands and acuity, the Calgary Health Region is renovating the intensive care units (ICU) at three of their adult acute care sites. Before finalising the design plans, mock-up rooms were created at two of the sites according to several proposed room designs in order to identify potential issues during the design phase of the project. All necessary equipment was included within each of the two mock-up rooms so as to nearly replicate a functioning ICU. Evaluations of equipment, room layout and conflicts were accomplished using patient simulation of a cardiac arrest, an acutely ill patient, a palliative care patient and the admission of a new patient. Digital videos, think aloud audio tracks and extensive debriefing sessions were combined and analyzed. Specific category issues were identified including the articulating arms, visibility of the patient monitors, equipment usability, collisions with equipment, and communication issues. Elaboration of each issue and presentation of design recommendations is given.
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Content Article
Health Education England: Human Factors Toolkit
Patient Safety Learning posted an article in Techniques
Health Education England have produced a toolkit on human factors in healthcare looking at example of training, simulation and speaking up. -
Content ArticleOperative vaginal birth is a common procedure used to expedite birth after full cervical dilatation where there is a clinical need to do so (15% of births in the UK in 2016). The acquisition of skills for operative vaginal birth is dependent on the exposure of junior obstetricians to situations in which they can undertake directly supervised learning.
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Content ArticleThe COVID-19 pandemic is challenging the Canadian emergency departments (EDs) in unparalleled ways. As part of the frontline response, EDs have had to adapt to the unique clinical difficulties associated with the constant threat of COVID-19, developing protocols and pathways in the setting of limited and evolving information. In addition to the disruption of routine clinical care practices, an underlying perception of danger has resulted in a challenging clinical environment in which to make time-sensitive, high-stakes decisions. This has created an urgent need for targeted and adaptive training for all members of the emergency medicine healthcare team. The following commentary, published here by the Cambridge University Press, reflects the perspective of four emergency medicine simulation educators during the Canadian response to COVID-19.
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Content ArticleI wrote this editorial for the Journal of Surgical Simulation after delivering the keynote talk at the Homerton Hospital, London Surgical Simulation conference in 2018. It outlines how aviation approaches error and its use of simulation in training to deal with it safely and efficiently. Aviation Safety Management Framework and the extensive use of simulation is a safe, value for money tool.
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Content ArticleHelen is a Consultant Anaesthetist at the Oxford University Hospitals NHS Foundation Trust (OUHFT) and a Senior Clinical Research Fellow in the Nuffield Department of Clinical Neurosciences, University of Oxford. Here, Helen highlights the importance of support and training and gives an example of how the OxSTaR team are transforming staff teamworking skills and improving patient safety.
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Content Article
‘Think SIM’ for your COVID-19 preparations
Claire Cox posted an article in Guidance
The COVID-19 pandemic has led to a widespread response across the NHS in terms of how staff and the departments and organisations in which they work can help to manage the challenges being faced now and in the coming weeks and months. This includes the need to learn new skills and procedures at short notice, to rehearse the management of complex and potentially hazardous clinical cases in unfamiliar environments, and to be assured that any systems, policies and protocols that are put into action are designed to promote safe, effective care and support staff well-being. There is an important role for simulation as a technique or intervention in this set of unique circumstances, which will be implemented more effectively if integrated and aligned with the many other initiatives aimed at supporting staff and the NHS as a whole. -
Content ArticleMartin Bromiley, Clinical Human Factors Group, talks to Claire Cox, Critical Care Outreach Nurse and Associate Director at Patient Safety Learning. In this podcast, Claire talks about the importance of simulation for all, using different scenarios to help raise confidence. She further describes some techniques her team are using to improve performance and safety when treating COVID-19 patients. Claire has recently written a blog on Human factors and the ad hoc team during the pandemic for the hub.
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Content Article
Human factors and the ad hoc team during the pandemic
Claire Cox posted an article in Blogs
In her latest blog, Claire, a critical care outreach nurse, reflects on how the 'ad hoc' team has to adapt to the new challenges the coronavirus pandemic brings. She offers insights into the challenges she and her team face and gives examples of potential solutions.- Posted
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Content ArticlePatient safety is the number one priority in health care as safety is considered at every level of a healthcare organisation (e.g., building, equipment, communication, processes for medications, treatments, and surgical procedures). Addressing the welfare of patients can be challenging, yet for some of the most vulnerable patients (e.g., special needs, disabilities and mental and social health issues), even the most routine nursing requests can put them at a safety risk. Simulations provide an opportunity for nursing students and professional nurses with realistic experiences caring for individuals with unique needs, especially when safety is a major concern.
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Content Article‘In Safe Hands’ is an interactive guide produced by Health Education England (HEE) who is responsible for delivering education and training that supports safer clinical practice across the NHS. This guide has been produced in response to the recommendations made in the 2016 report ‘Improving Safety Through Education & Training’.
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Content ArticleThe Department of health funded an initiative in 2013 to pioneer new approaches that would create a more integrated form of care. In order to receive funding, local Clinical Commissioning Groups were required to engage a range of stakeholders in a practical approach that generated the development of an integrated model of care. To fulfil this requirement, two sequential simulation (SqS) workshops were designed using real patient scenarios from the locality, covering the areas of general practice, community health and adult social care. They were attended by a diverse group of patients and frontline staff. In pre- and post-workshop questionnaires, attendees strongly agreed that they had had an opportunity to contribute to all discussions and raise questions, concerns and ideas (100%). Knowledge of current and new models of care was vastly improved and the opportunity to share information and to network was valued. The SqS approach seen as breaking professional barriers by 100% of attendees.
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Content ArticleThe Cambridge Elements series offers a comprehensive and authoritative set of overviews of different improvement approaches that can be applied to healthcare. Each publication explores the thinking behind them, examines evidence for each approach and identifies areas of debate. Publications available include: Design creativity Values and ethics Statistical process control Approaches to spread, scale-up, and sustainability Health economics Governance and leadership Workplace conditions Reducing overuse Simulation as an improvement technique Implementation science Operational research approaches Making culture change happen Co-producing and co-designing Collaboration-based approaches The positive deviance approach
