Board 115 - Program Innovations Abstract An Interprofessional Intensive Care - Laboratory Science, Medicine, Nursing and Respiratory Therapy Students and Trainees (Submission #560)

Abstract

Introduction/Background The value of interprofessional simulation is increasingly being documented. Our group sought to develop a multi-patient, multi-professional extended simulation session for laboratory science, medicine, nursing and respiratory therapy participants. The intent of the simulation was to challenge learners with significant complexity to allow for critical thinking, prioritization and team-based communication challenges. We created a very difficult afternoon in the intensive care unit (ICU) setting. Methods A multi-professional team including laboratory sciences, medicine, nursing and respiratory therapy developed a four patient ICU based extended time simulation experience. Patient profiles were created by the simulation team. A timeline and set of expected actions was carefully crafted. The patient record was created and included nursing documentation on ICU based flow sheet as well as timed laboratory results. The patients that were in the mock ICU included a recent transfer from the floor with presumed septic shock who develops a transfusion related lung injury reaction, an expected new admit from the emergency department with chronic obstructive pulmonary disease who needs bipap, a patient who recently received a tracheostomy and who is weaning off the respirator and a recent transfer from the floor with respiratory distress who is currently being evaluated for a pulmonary embolus. The nursing students arrived before the other learners and received check out from confederate nurses who were going off shift and had time to complete their assessments. The respiratory participants were briefed about available equipment and respiratory plan of care. Seven nurses, four laboratory students, two medical residents, one medical student and three respiratory therapy students participated in the simulation. Over 15 faculty members and confederates were present to assist with scenario flow, manikins management and debriefing. The entire scenario lasted 75 minutes and the debriefing was completed in stages, with a portion at the bedside, a portion with the entire group and additional discipline specific debriefing. Evaluation data included general evaluation which was solicited both in writing and in the form of a focus group. Participants were overwhelmingly positive about the experience. They highlighted the opportunity to practice the care of patients with other healthcare team members. Nursing students in particular had suggestions for improving the fidelity of the situation. Faculty involved provided feedback for future sessions. The faculty after action review focused on both discipline specific improvements, as well as overall opportunities for clarification. For example, for nursing and respiratory requested standardization of medications and supplies in a format that is more consistent with an actual ICU setting. The physicians reported that the fact that they were needed in many locations added to the realism but would have preferred to have the standard checkout sheet that they use in actual practice. Laboratory science students, who were located off site, would prefer to be closer to the action. Conclusion To our knowledge, this represents the first collaboration of these four disciplines in a multi-patient simulation scenario focusing on prioritization of multiple patients. The activity was well received; however, the quality of the simulation experience was likely related to the high proportion of faculty to students. Additional work is needed to streamline this educational effort to allow for widespread implementation. Reference ©1. Scherer et al. Interprofessional Simulation to Foster Collaboration between Nursing and Medical Students Clinical Simulation in Nursing (2013) e1-e9. Disclosures None.