High Fidelity Simulation to Evaluate Emergency Management in Urgent Care Centers.

Authors
Tabor, Megan ; Vaughn, Brooke L.

A large amount of literature discusses the use of simulation in academic and acute care settings, but few report the use of simulation in the urgent care setting or to train unlicensed personnel. Staff members in this setting are responsible for managing emergencies until medical services (EMS) respond. Cardiac emergencies in the urgent care setting are reported as acute low volume events, creating difficulties in preparation of staff. Inconsistencies were discovered with staff in managing situations at twelve urgent care centers in the metropolitan area. A clinical educator partnered with a university simulation educator to develop an in-situ cardiac emergency . The researchers evaluated the effect of simulation on competency of urgent care staff in managing a cardiac emergency prior to the arrival of EMS. A convenience sample of 128 urgent care staff precipitated in a chest pain using a high fidelity simulator. It was completed one time at each urgent care center. Participants included: RNs, LPNs, medical assistants, radiology technicians and receptionists. Scenario objectives included: recognizing a potentially life-threatening patient condition, implementing center protocol to notify EMS, management of a patient with basic life support upon arrival of EMS and of the team's performance. The Simulation Effectiveness and Creighton Competency Instrument (CCEI) were used to evaluate the experience. Participants were highly engaged, reflecting on all aspects of the simulation. Opportunities for learning were identified by participants relating to the CCEI criteria, including thorough system processes and effective communication with the team. Competent behaviors in managing emergencies did not correlate with previous experience in managing cardiac emergencies or years of experience in employee role. These reasons indicate a for continued simulation experiences in the urgent care setting. It is recommended that health care systems continue to collaborate with universities to implement simulation. Simulation was found to be an effective way to identify areas for continued education and simultaneously provide quality for unlicensed personnel to produce better patient outcomes in the urgent care setting.

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Simulation

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Simulation, qualitative research

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essential elements that to be considered by health professionals responding during an , including organizational, team building, and leadership skills

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Students would have to use their skills, communication skills, triage skills, patient safety skills, collaborative skills, documentations skills, and leadership skills to effectively manage the presenting infectious disease while addressing other health-related conditions.

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Simulation and qualitative , verbal briefing as group activity and written reflection by each individual after each simulation.

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Describe a public health simulation with undergraduate senior nursing students enrolled in a public health clinical course

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A limitation of this is that although objective criteria for performance were developed and implemented for the simulation, the objectives were not formally evaluated by the participants.Sarpy, Warren, Kaplan, Bradley, andHowe (2005) recommend that participants’ learning be evaluated 3–6months following a simulation exercis

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This public health simulation of infectious disease outbreaks can be a useful learning strategy at other educational institutions an  can be easily replicatedOur first recommendation is that presimulation briefing time should be increased from 15 to 30min.We also suggest adding an informatics component in the actual simulation. This would enhance the delivery of evidence-based care and patient safety

SLR Criteria
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Students participated in two separate simulated infectious disease outbreaks and were required to assume various responder and leadership roles as well as various casualty rolesThe infectious disease outbreak exercises took placein a simulated large, crowded urban high school thatserved a vulnerable and underserved population ofhigh school students.

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