From the Gossman Advanced Healthcare Simulation.
Swedish Center for Research and Innovation.
Pediatr Emerg Care. 2021 Sep 1;37(9):451-455. doi: 10.1097/PEC.0000000000001623.
Emergency department (ED) caregivers have reported feeling uncomfortable performing emergency pediatric procedures, likely because of either a lack of training or infrequent exposure to these events. To address these gaps, ongoing education for experienced ED caregivers must aim to improve caregiver confidence with high-risk, low-volume pediatric emergency care. This study used multidisciplinary, in situ simulations to facilitate improved caregiver confidence when treating pediatric emergencies in an ED setting.
Two-hour pediatric code blue simulations were held in 7 EDs throughout the Seattle, Washington, metropolitan area. Questionnaire data were collected from 353 simulation participants (60% nurses, 19.5% ED technicians, 14% ED physicians; median team size = 5) via pre simulation and post simulation surveys assessing confidence and understanding regarding interventions/treatments, standard protocols, culture of safety behavior, and team members' roles/responsibilities. Paired t tests were used to analyze changes in self-reported confidence.
Confidence improved across all questions (37%-57% of participants reported good/complete confidence pre simulation, improving 94%-98% post simulation; P < 0.00001 for all). Participants cited learning equipment location/use (37%), hands-on practice (32%), and discussion (22%) as the most helpful aspects of the simulations. Identified changes to practice made post simulation included more effective communication (18%) and utilization of a pediatric emergency drug sheet (13%).
Multidisciplinary, in situ simulation improves experienced ED caregivers' confidence with pediatric emergencies in an ED setting. These findings suggest that investment in simulation-based education may improve clinical care and quality and safety improvement plans for the treatment of pediatric emergencies in general EDs.
急诊（ED）护理人员报告称在进行儿科急诊操作时感到不舒服，这可能是由于缺乏培训或对这些事件的接触不足。为了解决这些差距，对有经验的 ED 护理人员的持续教育必须旨在提高护理人员对高风险、低容量儿科急诊护理的信心。本研究使用多学科、现场模拟来提高 ED 环境中儿科急诊治疗的护理人员信心。
在华盛顿州西雅图大都市区的 7 家 ED 中进行了两小时的儿科蓝色代码模拟。通过模拟前和模拟后问卷调查，从 353 名模拟参与者（60%为护士，19.5%为 ED 技术员，14%为 ED 医生；中位数团队规模=5）收集问卷数据，评估干预措施/治疗、标准方案、安全行为文化以及团队成员角色/职责的信心和理解。使用配对 t 检验分析自我报告信心的变化。
所有问题的信心均有所提高（37%-57%的参与者在模拟前报告有良好/完全的信心，模拟后提高 94%-98%；所有 P<0.00001）。参与者认为模拟最有帮助的方面是学习设备位置/使用（37%）、实践操作（32%）和讨论（22%）。模拟后，实践中做出的改变包括更有效的沟通（18%）和利用儿科急救药物表（13%）。
多学科、现场模拟提高了 ED 护理人员在 ED 环境中处理儿科急症的信心。这些发现表明，对基于模拟的教育的投资可能会改善一般 ED 中儿科急症的临床护理和质量及安全改进计划。
