Enhancing Situational Awareness and Patient Safety in Pediatrics Through Virtual Simulation

Background: Patient safety adverse events are a significant concern in pediatric healthcare in the US. Learning how to identify and report identified errors and near misses enables mitigation of current and future harm. An interactive in-person simulation activity at our institution has been successful in enhancing medical students and trainees' ability to identify and report patient safety hazards. Infection prevention precautions during the COVID-19 pandemic necessitated the rapid development of a virtual simulation training in 2020-2021. Our objectives were to assess the feasibility and effectiveness of a virtual simulation training to enhance medical students and trainees' awareness of and confidence in identifying and reporting patient safety hazards. Methods: Learners were 102 second year medical students starting clinical clerkships. Brief orientation videos reviewed learning objectives, instructions on navigating the 360-video virtual interface, and the simulated case - a 5 y/o boy in the emergency department with an acute asthma exacerbation. Learners then explored a 360 video in a virtual simulation environment to identify hazards that fell into the broad themes of falls, allergies, protected health information, personal protective equipment, hand hygiene, choking, medication administration, privacy, electronic health records, and infections. Learners then viewed brief instructional videos on these hazards, the importance of situational awareness, and how to report near misses and errors using our hospital incident reporting system. Effectiveness and learners experience was assessed through pre and post simulation questionnaires and learner interviews. Results: Key outcomes were frequency of safety issues identified and confidence in identifying and reporting hazards, errors and near misses. Scores of learner confidence in identifying and reporting patient safety hazards significantly increased (see Figure). Learners rated their overall satisfaction on a 0-10 scale (0= Not at all Satisfied, 10= Very Satisfied). Median learner satisfaction scores were 7. Learners reported that the virtual simulation was a good alternative to in-person training. Specific positive aspects identified were the short instructional videos with a variety of speakers, the concise nature of the activity, and learning to how to file incident reports. The increase in confidence in identifying and reporting patient safety hazards were lower in the virtual simulation compared to the in-person version. However, learners identified several strategies to enhance the experience in future years. Specific areas for improvement were zooming in capabilities on mobile devices and variation in experience depending on internet speed and device used. Conclusion: This brief interactive simulation activity was successful in enhancing learners' awareness of and confidence in identifying and reporting patient safety hazards. Our next steps include improving the immersive nature of the simulation experience, integrating more authentic components, replicating a team approach, and identifying platforms that are suited to a variety of mobile devices and internet speeds.

Assessing changes in stethoscope hygiene during COVID-19: a multi-centre cross-sectional study.

BACKGROUND: The COVID-19 (SARS-CoV-2) pandemic has increased infection control vigilance across several modes of patient contact. However, it is unknown whether hygiene pertaining to stethoscopes, which carry the potential for pathogenic contamination, has also shifted accordingly. AIM: To characterize pandemic-related changes in stethoscope hygiene. METHODS: We surveyed healthcare providers at three major medical centres. Questions quantitatively (Likert scale and frequency) assessed stethoscope hygiene beliefs and practices with two components: before and during COVID-19. Participants were grouped based on performance of optimal stethoscope hygiene (after every patient) before and during COVID-19. Groups were compared using χ2 and analysis of variance (ANOVA). FINDINGS: Of the 515 (10%) who completed the survey, 55 were excluded (N = 460). Optimal hygiene increased from 27.4% to 55.0% (P < 0.001). There were significant increases in Likert scores for all questions pertaining to knowledge of stethoscope contamination (P < 0.001). Belief in stethoscope contamination increased (P < 0.001) despite no change in perceived hygiene education. Resident physicians were less likely compared with attending physicians and nurses to have adopted optimal hygiene during COVID-19 (P < 0.001). CONCLUSION: Despite a positive shift in stethoscope hygiene during COVID-19, optimal hygiene was still only performed by around half of providers. Educational interventions, particularly targeting early-career providers, are encouraged.

Knowledge attitude and practice of general population after six months of outbreak covid-19

Aim: To assess the knowledge, attitude and practice of the general population after six months of outbreak. Methods: A cross-sectional survey was conducted on the general population in the month of July 2020. In which the general population was randomly selected and assessed for knowledge, attitude and practice about COVID19. The questionnaire was designed to avoid any privacy information and all questions were mandatory to answer. Results: Total of 1200 participants enrolled male 552(46%) and female 648(54%). Age ranges between 20 to 60 years and education status of responders were divided into middle, higher secondary and graduate respectively;they were 192(16%), 420(35%) and 588(49%). Knowledge assessed through symptom & virus transmission questions fever, fatigue and dry cough responded by 768(64%) while rest question knowledge were very poor. Practice questions responses to the virus were very much disturbing and most believe hype created by government and media, admission causes loss of loved ones and doctors are responsible for giving death injections to admitted peoples. Only 768(64%) of respondents regularly sanitize hands and wash with soap. Conclusion: Response to the question in KAP study was very poor despite six month had been passed in outbreak, yet it is necessary to improve the knowledge by arranging online seminars, media talk and strong awareness campaign required to improve knowledge & motivate their attitude toward virus which will resulting good practice to avoid further transmission of infection.