42 Novel use of high-fidelity simulation in the training of palliative care hospital liaison team nurses in the management of palliative care emergencies

Abstract

Introduction Northumbria Healthcare has a well-established hospital liaison palliative care team (HLT), working over 4 different hospital sites. Comprising mostly of palliative care nurses, they see patients throughout their hospital admissions, sometimes in emergency situations. The need to improve skills in this area was recognised, so we piloted a novel education package using simulation. Methods We delivered 3 half days of simulation training to 9 HLT palliative care nurses ranging from band 5 to 7 in seniority. The scenarios represented several emergency topics, including massive haemorrhage, seizures, hypercalcaemia, and superior vena cava obstruction. We used high-fidelity simulation manikins, with members of the simulation faculty role-playing healthcare professionals or relatives. The scenarios ran for 20 minutes followed by a 30 minute debrief. Evaluation forms were completed at the end, where participants rated their confidence levels before and after completing the scenario, how realistic the scenarios were, how helpful the debrief was, and whether they would recommend this style of teaching to their colleagues. They also gave free text comments. Results Most of the participants rated their confidence higher following the simulation than before it. Six participants agreed that they felt more confident managing similar scenarios for real with three strongly agreeing. All participants either agreed or strongly agreed that the simulation study day was a realistic representation of the cases they come across in their roles, with the majority of participants strongly agreeing that the debrief was helpful. The majority of participants strongly agreed they would recommend this style of teaching to their colleagues. Free text comments were overwhelmingly positive, particularly around how realistic the scenarios were and how safe the learning environment felt. Conclusions Simulation training in emergency palliative care scenarios for specialist palliative care nurses working within the HLT is a novel, effective and well accepted method of training.