Benlolo Samantha, Nensi Alysha, Campbell Douglas M, Assouad Caroline, Taylor Taryn S, Shore Eliane M
Obstetrics and Gynaecology, St. Michael's Hospital, Unity Health Toronto, Toronto, CAN.
Paediatrics, St. Michael's Hospital, Unity Health Toronto, Toronto, CAN.
Cureus. 2021 Jan 25;13(1):e12906. doi: 10.7759/cureus.12906.
Simulation's benefits in medical education are well established. However, its use for pandemic preparedness in obstetrics is lacking. Management of obstetrical patients with suspected COVID-19 infection is a complex task with safety considerations for mother, fetus and healthcare workers. Implementation of new workflow algorithms to ensure safety is critical but is challenging to implement in real-time. We sought to improve pandemic preparedness by designing and deploying a high-fidelity simulation exercise involving the admission of a labouring obstetrical patient with suspected COVID-19 into a labour room, urgent transfer to the operating room and neonatal resuscitation. The creation of the simulation scenario was a multi-disciplinary effort with input from a focus group of key clinical stakeholders from within and outside of our centre to ensure clinical validity. Simulations were performed on the clinical unit during regular work hours so workflow could be observed in real-time with access to the equipment and personnel in which this clinical scenario would occur. We completed a total of 11 simulation sessions involving 42 participants. Feedback, obtained from debrief sessions and anonymous surveys, was categorized based on the human factors framework, and used as part of an iterative process to adapt, revise and improve the simulation scenario. The result of this iterative process was the creation of validated departmental infection control protocols that continue to be implemented through the second wave of the COVID-19 pandemic.
模拟在医学教育中的益处已得到充分证实。然而，其在产科大流行防范中的应用却较为缺乏。对疑似感染新冠病毒的产科患者进行管理是一项复杂的任务，需要考虑母亲、胎儿和医护人员的安全。实施新的工作流程算法以确保安全至关重要，但实时实施具有挑战性。我们试图通过设计和开展一项高保真模拟演练来提高大流行防范能力，该演练涉及将一名疑似感染新冠病毒的临产产科患者收入产房、紧急转运至手术室以及新生儿复苏。模拟场景的创建是一项多学科工作，我们中心内外的关键临床利益相关者焦点小组提供了意见，以确保临床有效性。模拟在正常工作时间在临床科室进行，这样可以实时观察工作流程，同时可以使用该临床场景中会用到的设备和人员。我们总共完成了11次模拟演练，有42名参与者。从汇报环节和匿名调查中获得的反馈，根据人为因素框架进行分类，并作为迭代过程的一部分，用于调整、修订和改进模拟场景。这个迭代过程的结果是创建了经过验证的部门感染控制协议，这些协议在新冠疫情第二波期间仍在持续实施。
