High Fidelity Simulation to Evaluate Emergency Management in Urgent Care Centers.
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 emergency 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 emergency 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 scenario. 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 scenario 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 evaluation of the team's performance. The Simulation Effectiveness Tool and Creighton Competency Evaluation 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 need 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 training for unlicensed personnel to produce better patient outcomes in the urgent care setting.
Simulation
Simulation, qualitative research
essential elements that need to be considered by health professionals responding during an emergency, including organizational, team building, and leadership skills
Students would have to use their assessment skills, communication skills, triage skills, patient safety skills, collaborative skills, documentations skills, and leadership skills to effectively manage the presenting infectious disease emergency while addressing other health-related conditions.
Simulation and qualitative evaluation, verbal briefing as group activity and written reflection by each individual after each simulation.
Describe a public health emergency simulation exercise with undergraduate senior nursing students enrolled in a public health clinical course
A limitation of this exercise 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
This public health emergency preparedness simulation exercise 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
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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