RESUMO
The coronavirus disease 2019 (COVID-19) pandemic has created many challenges for health care providers. At the forefront is the need to balance optimal patient care with the safety of those providing that care. This is especially true during resuscitations where life-saving procedures cause widespread aerosolization of the virus. Efforts to mitigate this exposure to front-line providers are therefore paramount. We share how we used simulation to prepare our pediatric emergency department for COVID-19 resuscitations.
Assuntos
Infecções por Coronavirus/terapia , Serviço Hospitalar de Emergência , Pessoal de Saúde/educação , Pneumonia Viral/terapia , Ressuscitação/educação , Treinamento por Simulação/métodos , Betacoronavirus , COVID-19 , Criança , Humanos , Pandemias , SARS-CoV-2 , Integração de SistemasAssuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Equipe de Assistência ao Paciente/organização & administração , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Betacoronavirus/isolamento & purificação , COVID-19 , Simulação por Computador , Delaware/epidemiologia , Humanos , Modelos Organizacionais , Pandemias , Equipe de Assistência ao Paciente/normas , SARS-CoV-2 , Fluxo de TrabalhoRESUMO
Closed-loop communication (CLC) promotes a shared understanding of information. The authors hypothesized that simulation-based CLC training would improve staff perceptions of CLC ability and decrease medical errors. Participants experienced 2 hands-on CLC simulations one month apart. A retrospective chart review of Emergency Severity Index (ESI) 1 patients was conducted 4 months pre and post CLC simulation-based training. Seventy simulations were held over 13 weeks. Staff perceptions of CLC ability improved and were sustained after one month. Nine ESI 1 patients were seen pre CLC, and 9 post; 8/9 pre-CLC ESI 1 patients had medical errors, with 19 total errors noted; 5/9 post-CLC ESI 1 patients had medical errors, with 5 total errors noted (rate ratio [99% CI] = 3.8 [1.4, 10.2]; P = .008). This simulation-based CLC training curriculum improved staff perceptions of their CLC ability and was associated with a significant decrease in the number of medical errors in ESI 1 patients.