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Interdisciplinary onsite team-based simulation training in the neonatal intensive care unit: a pilot report

Abstract

Objective:

Simulation training improves individual clinician confidence, performance and self-efficacy in resuscitation and procedural training experiences. The reality of resuscitation experiences in the neonatal intensive care unit (NICU) is that they are team-accomplished events. However, limited data exist on team-based simulation training (TBST) in the NICU. We report the experience of TBST over a 4-year period.

Study Design:

This is a retrospective report of 65 TBST events in a 71-bed Level IV NICU at a regional subspecialty children’s hospital. Participants were more than 500 NICU staff, including neonatal/cardiac/surgical attendings, neonatal fellows, neonatal nurse practitioners, pediatric residents, registered nurses and respiratory therapists. Background work, common case scenarios, training objectives and learning opportunities were reported, along with discipline-specific, and team and system areas for improvement. Qualitative, subjective data were tracked and efforts at collecting quantitative, objective data are ongoing.

Results:

Seventy-five TBST events were scheduled from November 2010 through December 2014; 10 of these were canceled. TBST events occurred both night (n=23) and day (n=42), and also on weekends (n=19), using high-fidelity (n=42) and low-fidelity (n=23) systems. Resuscitation team participants at each TBST were 12–30 providers and staff. The duration of each TBST event was 30–65 min including debriefing. Systems issues were identified and corrected, including problems activating the code pathway, issues using a pager activation system and confusion over resuscitation team roles and responsibilities. Educational needs were addressed, focused on topic areas that included arrhythmias and use of extracorporeal cardiopulmonary resuscitation.

Conclusion:

With appropriate planning and implementation, TBST is feasible and realistic in a busy NICU.

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References

  1. Bonafide CP, Localio AR, Roberts KE, Nadkarni VM, Weirich CM, Keren R . Impact of rapid response system implementation on critical deterioration events in children. JAMA Pediatr 2014; 168 (1): 25–33.

    Article  Google Scholar 

  2. Tibballs J, Kinney S . Reduction of hospital mortality and of preventable cardiac arrest and death on introduction of the pediatric medical emergency team. Pediatr Crit Care Med 2009; 10 (3): 306–312.

    Article  Google Scholar 

  3. Kotsakis A, Lobos AT, Parshuram C, Gilleland J, Gaiteiro R, Mohseni-Bod H et al. Implementation of a multicenter rapid response system in the pediatric academic hospitals is effective. Pediatrics 2011; 128 (1): 72–78.

    Article  Google Scholar 

  4. Theilen U, Leonard P, Jones P, Ardill R, Weitz J, Agrawal D et al. Regular in situ simulation training of paediatric medical emergency team improves hospital response to deteriorating patients. Resuscitation 2013; 84 (2): 218–222.

    Article  CAS  Google Scholar 

  5. Watters C, Reedy G, Ross A, Morgan N, Handslip R, Jaye P . Does interprofessional simulation increase self-efficacy: a comparative study. BMJ Open 2015; 5: e005472.

    Article  Google Scholar 

  6. Maxson PM, Dozois EJ, Holubar SD, Wrobleski DM, Overman Dube AJ, Klipfel JM et al. Enhancing nurse and physician collaboration in clinical decision making through high-fidelity interdisciplinary simulation training. Mayo Clin Proc 2011; 86 (1): 31–36.

    Article  Google Scholar 

  7. Deering S, Johnston LC, Colacchio K . Multidisciplinary teamwork and communication training. Semin Perinatol 2011; 35 (2): 89–96.

    Article  Google Scholar 

  8. Thomas EJ, Taggart B, Crandell S, Lasky RE, Williams AL, Love LJ et al. Teaching teamwork during the Neonatal Resuscitation Program: a randomized trial. J Perinatol 2007; 27 (7): 409–414.

    Article  CAS  Google Scholar 

  9. Rosen MA, Hunt EA, Pronovost PJ, Federowicz MA, Weaver SJ . In situ simulation in continuing education for the health care professions: a systematic review. J Contin Educ Health Prof 2012; 32 (4): 243–254.

    Article  Google Scholar 

  10. Miller KK, Riley W, Davis S, Hansen HE . In situ simulation: a method of experiential learning to promote safety and team behavior. J Perinat Neonatal Nurs 2008; 22 (2): 105–113.

    Article  Google Scholar 

  11. Guise JM, Mladenovic J . In situ stimulation: identification of systems issues. Semin Perinatol 2013; 37 (3): 161–165.

    Article  Google Scholar 

  12. Rubio-Gurung S, Putet G, Touzet S, Gauthier-Moulinier H, Jordan I, Beissel A et al. In situ simulation training for neonatal resuscitation: an RCT. Pediatrics 2014; 134 (3): e790.

    Article  Google Scholar 

Download references

Acknowledgements

We thank the Children’s Mercy NICU Code Blue Committee, the CPS and the unit staff and providers for their commitment to and continuing efforts with the TBST process. We thank Drs Steven Olsen, Julie Weiner and Joshua Petrikin, as well as Mrs Kayla Seever, Ms Jennifer Sylvester, Ms Amber Bellinghausen and Mr James McBrien for their assistance with manuscript preparation. No external funding was secured for this project. The first draft of this manuscript was authored by DJW Reed, MD, and no form of payment was given to anyone in its production.

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Correspondence to D J W Reed.

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Supplementary Information accompanies the paper on the Journal of Perinatology website

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Reed, D., Hermelin, R., Kennedy, C. et al. Interdisciplinary onsite team-based simulation training in the neonatal intensive care unit: a pilot report. J Perinatol 37, 461–464 (2017). https://doi.org/10.1038/jp.2016.238

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