COVID-19 Emergency Department Protocols: Experience of Protocol Implementation Through in-situ Simulation
| Autor: | Anmol Purna Shrestha, Abha Shrestha, Roshana Shrestha, Taylor Sonnenberg |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Protocol (science)
business.industry medicine.medical_treatment Debriefing 030208 emergency & critical care medicine Emergency department 030204 cardiovascular system & hematology Emergency Nursing medicine.disease Triage Checklist 03 medical and health sciences 0302 clinical medicine Preparedness Emergency Medicine Medicine Intubation Airway management Medical emergency business |
| Zdroj: | Open Access Emergency Medicine. 12:293-303 |
| ISSN: | 1179-1500 |
| DOI: | 10.2147/oaem.s266702 |
| Popis: | Purpose During the outbreak of Coronavirus disease of 2019 (COVID-19), the preparedness of emergency departments (EDs) for triaging of the patients and safety of staff is of utmost importance. The aim of our study was to develop and implement COVID-19 ED triage and protected intubation protocols for COVID-19 patients with in-situ simulation (ISS) training. The latent safety threats (LST) detection also served as a platform to test new system amendments and refine the protocols and workflows with infection control issues. We also explored the effectiveness of this approach based on Kirkpatrick's model of evaluating training outcomes. Participants and Methods The protocols and simulation scenarios were developed and validated. A total of 22 triage and 13 intubation simulation sessions were conducted in the ED with multidisciplinary staff (physicians=18, nurses=20) during a period of four months. Each simulation was followed by a debriefing session to discuss the team performance. Pre- and post-simulation performances were compared. LSTs were identified and remediated. An online voluntary feedback was collected from the participants to explore the opinion about the ISS sessions and confidence level using a 5-point Likert scale. Results There was a significant improvement in triage knowledge score after ISS [5.5/10 (IQR 4-6) versus 8.5/10 (IQR 8-9), p 75%) following the ISS for triage case scenarios. A pre-designed checklist was used during protective intubation simulations. Some important LSTs were missing medications, lack of mechanism to deliver patient samples to lab and faulty airway maneuvers. The participants' feedback on ISS showed increased skills and confidence level on triaging and protected intubation (p |
| Databáze: | OpenAIRE |
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