Using Simulation to Improve Systems-Based Practices

In Situ Simulation: A Strategy to Restore Patient Safety in Intensive Care Units after the COVID-19 Pandemic? Systematic Review

BACKGROUND

Patient safety is a public health problem worldwide. In situ simulation (ISS) arises as a learning strategy that allows health professionals to immerse themselves in a real environment without endangering the patients until they have learned the skills needed, thus increasing the quality of care. This systematic review aimed to verify the efficacy of the use of "in situ simulation" as a method that will allow health professionals to increase patient safety in Intensive Care Units after the situation experienced during the pandemic caused by the COVID-19 virus.

METHODS

Seven studies were reviewed using the PRISMA methodology for systematic reviews. The CASPe guide was used to assess the quality of the manuscripts.

RESULTS

The main topics that emerged from this review in relation to in situ simulation were as follows: looking at aspects such as patient self-perception of safety, adverse events, interprofessional communication and health system organization in relation to in situ simulation.

CONCLUSIONS

The adequate implementation of in situ simulation after the COVID-19 pandemic in ICU services is shown to be an efficient and effective strategy to promote improvement in the attitudes on a culture of safety and teamwork of professionals.

Using Simulation-Based Education to Improve Team Communication During a Massive Transfusion Protocol in the OR

Hemorrhaging during operative and other invasive procedures can result in devastating outcomes for surgical patients. An effective plan of action in the form of a massive transfusion protocol (MTP), along with teamwork and clear communication among OR personnel, is critical during a hemorrhagic crisis to improve patient outcomes. However, perioperative personnel may be unprepared to manage a hemorrhagic crisis because they lack experiential knowledge of these uncommon, high-risk scenarios. Perioperative leaders at a 500-bed acute-care hospital in the Midwest developed an educational activity involving a video-recorded simulated MTP scenario, learning modules, and debriefing sessions to educate more than 150 employees. Perioperative personnel received pre-education and watched the video-recorded MTP simulation together, and then participated in team debriefings after watching the video. Based on team debriefings and evaluation feedback, most staff members believed that the activity improved team communication.