Planning for a potential paediatric bronchiolitis surge: How Inter-Professional Education (IPE) was used to build a practice-ready clinical team

ABSTRACT

Introduction: Bronchiolitis is the most common cause for paediatric respiratory hospital admissions in young children in the UK.1 Following the relaxation of international SARS-Cov-2 lockdown measures a potential national surge in cases was predicted, highlighting a need for more collaborative working across core specialities.2 This prompted the use of the principles of Inter-Professional Education (IPE) to prepare and deliver an intervention to improve outcomes for these patients.3 Objectives: * To plan, deliver and evaluate an educational intervention focussed on improving the knowledge, skills and attitudes needed to care for a sick child with bronchiolitis * To utilise the principles of IPE to improve competence and confidence across core specialities involved in the care of a sick child with bronchiolitis Methods: A team from the Adult Intensive Care Unit (AICU) and the Paediatric High Dependency Unit (PHDU) from the Royal Berkshire Hospital in Reading delivered an inter-professional teaching session focussed on caring for the sick child with bronchiolitis. The patient journey was utilised as a framework to teach the core knowledge, skills and attitudes needed to clinically manage a child from the Emergency Department (ED) to the Intensive Care Unit (ICU). Each session included a lecture about bronchiolitis - describing pathophysiology and how to recognise the deteriorating child;a skills and drills tutorial - highlighting the need for weight-based calculations for high flow nasal oxygen, intravenous fluids and drugs;and a practical simulation scenario - focussing on the stabilisation and management of a sick child awaiting retrieval to the Paediatric Intensive Care Unit (PICU). Result(s) 135 healthcare professionals from a range of adult and paediatric disciplines involved in the care of children across the patient journey attended one of fourteen teaching sessions delivered between September to December 2021. Attendees completed a feedback questionnaire. One hundred and twenty-two (90%) reported an extremely high degree of satisfaction overall, with many saying they would recommend the teaching sessions to others. Areas of personal and professional development were highlighted across the following main themes gaining theoretical knowledge;understanding key equipment;performing drug calculations;preparing for intubation and ventilation;assessing the need for chest physiotherapy techniques;and more collaborative team-working. Free text comments demonstrated that the attendees felt the teaching sessions built confidence through the sharing of new or improved knowledge and skills;facilitated a safe space to practice using simulation;and provided the opportunity to learn about and from each other. Many of the attendees also commented on areas they wanted to reinforce and further develop in daily clinical practice as a direct result of the sessions. Conclusion(s) On-going evaluation is taking place as the teaching sessions continue throughout the year, facilitating the inclusion of additional inter-professional groups from across core specialities. These sessions have been used as a template for the development of further planned IPE with a more varied range of paediatric clinical cases and presentations. These will continue to build on the transferable knowledge and skills that increase competence and confidence in caring for the sick child whilst developing a more collaborative practice-ready workforce.