In Situ Simulation in an Ambulatory Surgery Center

Abstract

<h3>Background Information</h3> An ambulatory surgery center exemplifies a positive trend of successful transformation in healthcare delivery outside of a hospital setting that has proven to improve quality and customer service. Yet, with the development of shorter-acting anesthetic drugs, multimodal analgesia and minimally invasive surgery within this environment, perioperative emergencies can occur. Due to the rarity of occurrence in this setting, management has the potential to be challenging due to the limited resources and fast-paced environment. In situ simulation is an educational modality built on the principles of adult learning theories geared towards cultivating emergency response preparedness, professionals' competencies and collaborative practice to promote patient safety and outcomes. <h3>Objectives of Project</h3> To implement efficient in situ simulations in the operating room and perianesthesia units to foster optimal performance in crisis resource management situations. Enhance professional skills and behaviors such as collaboration, communication, leadership, self-efficacy, decision-making, role responsibility and situational awareness to ensure team functioning for safe patient care. <h3>Process of Implementation</h3> An interprofessional team was developed and members had the opportunity to attend a comprehensive instructor workshop from the Center for Medical Simulation. They learned how to develop a simulation with measurable objectives and how to implement the components consisting of pre-briefing, the scenario and debriefing. A Laerdal SimMan Essential was provided and education on how to navigate the computer system and become familiarize with the capabilities of the manikin occurred. Team members collaborated to develop scenarios to disseminate simulations tailored to our specific patient populations. Currently simulations are performed once or twice monthly in either OR or perianesthesia settings. The processes are continuously being re-evaluated based on the feedback from the team, our participants and the addition of services. <h3>Statement of Successful Practice</h3> Based on the interdisciplinary Simulation Effectiveness tool (ID-SET) secure real-time online-survey, participants response has been overwhelmingly positive. The opportunity to breakdown the causes of poor communication, ambiguity of roles, correct diagnosis, treatment and team functioning is commended. <h3>Implications for Advancing the Practice of Perianesthesia Nursing</h3> Opportunity to develop and disseminate real-life scenarios in a safe, controlled environment. Debriefing encourages an engaging environment for participants to evaluate their response to a critical event, working individually and as a team to care for a patient.