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"In Situ Simulation"

Lise Brogaard, Lone Hvidman, Kim Hinshaw, Ole Kierkegaard, Tanja Manser, Peter Musaeus, Julie Arafeh, Kay I Daniels, Amy E Judy, Niels Uldbjerg
INTRODUCTION: This study aimed to develop a valid and reliable TeamOBS-PPH tool for assessing clinical performance in the management of postpartum hemorrhage (PPH). The tool was evaluated using video-recordings of teams managing PPH in both real-life and simulated settings. MATERIAL AND METHODS: A Delphi panel consisting of 12 obstetricians from the UK, Norway, Sweden, Iceland, and Denmark achieved consensus on a) the elements to include in the assessment tool, b) the weighting of each element, and c) the final tool...
February 27, 2018: Acta Obstetricia et Gynecologica Scandinavica
Conall Francoeur, Sarah Shea, Margaret Ruddy, Patricia Fontela, Farhan Bhanji, Saleem Razack, Ronald Gottesman, Tanya Di Genova
OBJECTIVES: To evaluate in-situ simulation to prepare a PICU to move to a new, redesigned unit. METHODS: The study setting is an academic PICU. This is a cross-sectional study using in-situ simulations of common PICU admissions. Postsimulation, participants completed a survey comparing the perception of preparedness pre- and postsimulation (via a 10-point Likert scale). Participants were resurveyed 6 months postmove to assess whether effects persisted. Qualitative data were obtained via thematic review of the survey comment section and from postsimulation debriefing...
February 15, 2018: Hospital Pediatrics
Meital Ben-Ari, Gilad Chayen, Ivan P Steiner, Dana Aronson Schinasi, Oren Feldman, Itai Shavit
In many countries, procedural sedation outside of the operating room is performed by pediatricians. We examined if in situ sedation simulation training (SST) of pediatricians improves the performance of tasks related to patient safety during sedation in the Emergency Department (ED). We performed a single-center, quasi-experimental, study evaluating the performance of sedation, before-and-after SST. Sixteen pediatricians were evaluated during sedation as part of their usual practice, using the previously validated Sedation-Performance-Score (SPS)...
January 25, 2018: Journal of Anesthesia
Michelle Davison, Frances B Kinnear, Paul Fulbrook
Aim: To assess the utility of a multiple-encounter in-situ (MEIS) simulation as an orientation tool for multidisciplinary staff prior to opening a new paediatric emergency service. Methods: A single-group pretest/post-test study was conducted. During the MEIS simulation, multidisciplinary staff with participant or observer roles managed eight children (mannequins) who attended triage with their parent/guardians (clinical facilitators) for a range of emergency presentations (structured scenarios designed to represent the expected range of presentations plus test various clinical pathways/systems)...
October 2017: BMJ Simul Technol Enhanc Learn
Jill McArdle, Asta Sorensen, Christina I Fowler, Samantha Sommerness, Katrina Burson, Leila Kahwati
OBJECTIVE: To assess implementation of safety strategies to improve management of births complicated by shoulder dystocia in labor and delivery units. DESIGN: Mixed-methods implementation evaluation. SETTING/LOCAL PROBLEM: Labor and delivery units (N = 18) in 10 states participating in the Safety Program for Perinatal Care (SPPC). Shoulder dystocia is unpredictable, requiring rapid and coordinated action. PARTICIPANTS: Key informants were labor and delivery unit staff who implemented SPPC safety strategies...
January 2, 2018: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
Xianwei Song, Yang Gao, Sophie M Green, Jennifer A J Dungait, Tao Peng, Timothy A Quine, Bailian Xiong, Xuefa Wen, Nianpeng He
Karst topography covers more than 1/3 of the People's Republic of China in area. The porous, fissured, and soluble nature of the underlying karst bedrock (primarily dolomite and limestone) leads to the formation of underground drainage systems. Karst conduit networks dominate this system, and rainfall takes a crucial role on water cycle at China karst area. Nitrogen loss from the karst system is of particular concern, with regard to nutrient use efficiency as well as water quality, as much of the karst system, including steeply sloping terrain, is used for intensive agriculture...
December 2017: Ecology and Evolution
Jessica H Katznelson, Jiangxia Wang, Martha W Stevens, William A Mills
OBJECTIVES: Critical access hospitals (CAH) see few pediatric patients. Many of these hospitals do not have access to physicians with pediatric training. We sought to evaluate the impact of an in situ pediatric simulation program in the CAH emergency department setting on care team performance during resuscitation scenarios. METHODS: Five CAHs conducted 6 high-fidelity pediatric simulations over a 12-month period. Team performance was evaluated using a validated 35-item checklist representing commonly expected resuscitation team interventions...
January 2018: Pediatric Emergency Care
Kathleen Gibbs, Samuel DeMaria, Scarlett McKinsey, Andrea Fede, Anne Harrington, Deborah Hutchison, Carol Torchen, Adam Levine, Andrew Goldberg
OBJECTIVE: To describe the successful implementation of an in situ simulation program to diagnose and correct latent safety threats in a level 4 neonatal intensive care unit (NICU) to mitigate a methicillin-resistant Staphylococcus aureus (MRSA) outbreak. STUDY DESIGN: An investigational report describes a simulation intervention that occurred during a 4-month MRSA outbreak in a single-center, 46-bed, newly renovated level 4 NICU. The simulation program was developed for all NICU providers in which they were exposed to a 30-minute in situ human simulation intervention that included education, evaluation, and debriefing to resolve perceived or observed latent safety threats...
March 2018: Journal of Pediatrics
Rachel Sunley, Karen Moloney, Jessica Parker, Christopher Arrowsmith, Kirsty Brown, Alex Wilson
: Emergency Medicine requires a highly skilled workforce who are passionate about delivering excellent patient care. Shift patterns linked with the ever increasing numbers of patients who attend Emergency Departments puts strain on educating the workforce and fostering team togetherness.Our objective in devising and instigating the 'Mini Sim' programme was to embed regular in-situ simulation training to enhance the learning of all staff within our Emergency Department team, building a highly trained workforce to deliver excellent care within the remit of our busy department...
December 2017: Emergency Medicine Journal: EMJ
Fenton O'Leary, Ioannis Pegiazoglou, Kathryn McGarvey, Ruza Novakov, Ingrid Wolfsberger, Jennifer Peat
OBJECTIVE: To measure scenario participant and faculty self-reported realism, engagement and learning for the low fidelity, in situ simulations and compare this to high fidelity, centre-based simulations. METHODS: A prospective survey of scenario participants and faculty completing in situ and centre-based paediatric simulations. RESULTS: There were 382 responses, 276 from scenario participants and 106 from faculty with 241 responses from in situ and 141 from centre-based simulations...
November 16, 2017: Emergency Medicine Australasia: EMA
Lindsay D Nadkarni, Cindy G Roskind, Marc A Auerbach, Aaron W Calhoun, Mark D Adler, David O Kessler
AIM: The aim of this study was to assess the validity of a formative feedback instrument for leaders of simulated resuscitations. METHODS: This is a prospective validation study with a fully crossed (person × scenario × rater) study design. The Concise Assessment of Leader Management (CALM) instrument was designed by pediatric emergency medicine and graduate medical education experts to be used off the shelf to evaluate and provide formative feedback to resuscitation leaders...
November 8, 2017: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
Lilly Bayouth, Sarah Ashley, Jackie Brady, Bryan Lake, Morgan Keeter, David Schiller, Walter C Robey, Stephen Charles, Kari M Beasley, Eric A Toschlog, Shannon W Longshore
BACKGROUND: Outcome disparities between urban and rural pediatric trauma patients persist, despite regionalization of trauma systems. Rural patients are initially transported to the nearest emergency department (ED), where pediatric care is infrequent. We aim to identify educational intervention targets and increase provider experience via pediatric trauma simulation. METHODS: Prospective study of simulation-based pediatric trauma resuscitation was performed at three community EDs...
October 13, 2017: Journal of Pediatric Surgery
Marianne Bittle, Kathleen O'Rourke, Sindhu K Srinivas
OBJECTIVE: To develop an interdisciplinary, interactive, skills review program to improve team responses during a postpartum hemorrhage (PPH). DESIGN: Online didactic modules in combination with an interdisciplinary skills program consisting of seven hemorrhage-related stations. SETTING/LOCAL PROBLEM: The project was conducted in the Women's Health Department in a quaternary-care Magnet- and Baby Friendly-designated academic medical center in Philadelphia, Pennsylvania...
March 2018: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
Claire Stewart, Jamie Shoemaker, Rachel Keller-Smith, Katherine Edmunds, Andrew Davis, Ken Tegtmeyer
OBJECTIVE: Pediatric code blue activations are infrequent events with a high mortality rate despite the best effort of code teams. The best method for training these code teams is debatable; however, it is clear that training is needed to assure adherence to American Heart Association (AHA) Resuscitation Guidelines and to prevent the decay that invariably occurs after Pediatric Advanced Life Support training. The objectives of this project were to train a multidisciplinary, multidepartmental code team and to measure this team's adherence to AHA guidelines during code simulation...
October 16, 2017: Pediatric Emergency Care
Birgit Wieland, Sven Ropte
The production of rotor blades for wind turbines is still a predominantly manual process. Process simulation is an adequate way of improving blade quality without a significant increase in production costs. This paper introduces a module for tolerance simulation for rotor-blade production processes. The investigation focuses on the simulation of temperature distribution for one-sided, self-heated tooling and thick laminates. Experimental data from rotor-blade production and down-scaled laboratory tests are presented...
October 5, 2017: Materials
Kamal Abulebda, Riad Lutfi, Travis Whitfill, Samer Abu-Sultaneh, Kellie J Leeper, Elizabeth Weinstein, Marc A Auerbach
BACKGROUND: More than 30 million children are cared for across 5,000 US emergency departments each year (ED). Most of these EDs are not facilities designed and operated solely for children. A web-based survey provided a national and state-by-state assessment of pediatric readiness and noted a national average score was 69 on a 100-point scale. This survey noted wide variations in ED readiness with scores ranging from 61 in low-pediatric-volume EDs to 90 in the high-pediatric-volume EDs...
October 4, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Mary Lavelle, Chris Attoe, Christina Tritschler, Sean Cross
BACKGROUND: In the UK, people with severe mental illness die up to 20years earlier than the general population, prompting increased focus on physical health in mental illness. However, training for mental health inpatient staff to meet patients' physical health needs has not received the same attention, with physical health training often being reactive and lacking evidence of effectiveness. OBJECTIVES: To evaluate an interprofessional, in situ, simulation training intervention for managing medical deterioration in mental health settings...
December 2017: Nurse Education Today
Viji Kurup, Veronica Matei, Jessica Ray
PURPOSE OF REVIEW: Simulation has now been acknowledged as an important part of training in healthcare, and most academic hospitals have a dedicated simulation center. In-situ simulation occurs in patient care units with scenarios involving healthcare professionals in their actual working environment. The purpose of this review is to describe the process of putting together the components of in-situ simulation for training programs and to review outcomes studied, and challenges with this approach...
December 2017: Current Opinion in Anaesthesiology
Jonathan Wong, Emer Finan, Douglas Campbell
Introduction Simulation is used for the delivery of education and on occasion assessment. Before such a tool is used routinely in neonatal training programs across Canada, a need assessment is required to determine its current usage by accredited training programs. Our aim was to characterize the type of simulation modalities used and the perceived simulation-based training needs in Canadian neonatal-perinatal medicine (NPM) training programs. Methods A 22-item and 13-item online descriptive survey was sent to all NPM program directors and fellows in Canada, respectively...
July 8, 2017: Curēus
Barbara M Walsh, Sandeep Gangadharan, Travis Whitfill, Marcie Gawel, David Kessler, Robert A Dudas, Jessica Katznelson, Megan Lavoie, Khoon-Yen Tay, Melinda Hamilton, Linda L Brown, Vinay Nadkarni, Marc Auerbach
BACKGROUND: Errors in the timely diagnosis and treatment of infants with hypoglycemic seizures can lead to significant patient harm. It is challenging to precisely measure medical errors that occur during high-stakes/low-frequency events. Simulation can be used to assess risk and identify errors. OBJECTIVE: We hypothesized that general emergency departments (GEDs) would have higher rates of deviations from best practices (errors) compared to pediatric emergency departments (PEDs) when managing an infant with hypoglycemic seizures...
October 2017: Journal of Emergency Medicine
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