ASCIA‐P31: PRACTICE MAKES PERFECT: THE USE OF SIMULATION IN ANAPHYLAXIS TREATMENT TO IMPROVE CLINICAL SKILLS THAT CAN LEAD TO IMPROVED PATIENT OUTCOMES

Abstract

Anaphylaxis is a life-threatening, allergic emergency needing prompt, appropriate treatment. Nurses working in hospitals receive regular anaphylaxis management training. However, nurses working in non-acute environments, such as private or general practices, only receive update training at the employer's or nurse's own discretion. Simulation has been successfully used for updating anaphylaxis skills in nursing and medicine (Oleary et al. 2013; Mason & Lyons 2013) and ambulance staff (Lamers et al. 2014) enabling staff reflection. Such opportunities are rare for staff working outside acute environments. A pilot simulation exercise was held in a university nursing school practice-based simulation laboratory, during an Australian Allergy Nursing conference, to highlight gaps in nurses’ knowledge, improve their clinical experience and critical event management of anaphylaxis. Evaluation was undertaken by a pre-and post-event questionnaire. Twelve participants participated two 20 minute anaphylaxis simulations. Scenario 1 involved recognition and treatment of a 6 year old child who developed anaphylaxis to peanut in a community-based setting. The second involved recognition and treatment of a 55 year old female who experienced anaphylaxis in a hospital allergy clinic while undergoing bee-venom immunotherapy. Specialist Allergy Nurses facilitated the filmed simulation exercise. For 30 minutes prior to the simulation, participants also practiced with equipment discussing emergency situation, communication and decision making activities related to anaphylaxis. Debriefing and re-playing of the simulation recordings assisted participants to reflect on their participation, actions and learning. Nurses valued the opportunity to participate in the simulation environment. Common to both scenarios were team-work errors, delays in communicating, documenting and administering adrenalin. Nurses found the exercise identified and improved their skills in anaphylaxis management in a non-threatening environment and suggested it be incorporated in allergy programs annually.