Welcome

Laerdal SUN 2009

Dallas, Texas

Brief Introduction
Susan Lucot, MSN, RN
Nurse Educator, SimMedical

Laura Mosesso
Project Manager, SimMedical

Agenda
Tell us about you!
Audience Response System

What are Response Teams and Initial

Providers
Simulation Session
Debriefing Exercise
Curriculum Exercise
Product Review
Question and Answer Session

What is your primary

role at your facility?
1. Clinician
2. Clinical Educator
3. Educator (Not
clinically active)
4. Administrator
5. Simulation
Operator
6. Other

If you are a clinician, tell

us more!
1. RN
2. MD
3. Respiratory
Therapist
4. Paramedic / EMT
5. Other

Why are you here?

Are you interested in
1. Rapid response team training
2. Initial in-hospital responder
training (prior to code team
arrival)
3. Learning what others are
doing
4. Looking for ways to improve
what you are already doing

What are you currently

doing for team or initial
responder training?
1. Course material
only
2. Course material
and simulation
sessions
3. Simulation
sessions only
4. Not teaching

Why Simulation-Based
Training?
In the United States:
Average 1.2 million healthcare related
incidents per year
$29 billion a year associated with medical
errors
66% of those errors are associated with
communication issues

Why Simulation-Based
Training?
According to the 1999 Institute of
Medicine Report To Err Is Human,
approximately 100,000 Americans die each
year from preventable hospital errors.
The annual toll exceeds the combined
number of deaths and injuries from motor
vehicle and airline crashes, suicides, falls,
poisonings and drownings.

Why Simulation-Based
Training?
To Err Is Human; Building a Safer Health System
The Committee believes that health
care organizations should establish
team training programs for personnel
in critical care areas (e.g., the
emergency department, intensive
care unit, operating room) using
proven methods such as the crew
resource management techniques
employed in aviation, including
simulation.

WHAT is Rapid Response

Team Training?
Also known as Crisis Team Training (CTT), Medical
Emergency Response Team (MET), Code Team.
Teams of clinicians rush to a patients location
whenever a clinician feels the patients
condition is deteriorating or has deteriorated
Teams are designed to rescue patients early in
their decline, before an adverse outcome occurs
Hospitals using rapid response teams typically
report reductions in the number of cardiac arrests,
unplanned transfers to the ICU and in some cases,
overall mortality rates

WHY Rapid Response

Team Training?
The Joint Commission
2008 National Patient Safety
Goals
Goal 16: Improve recognition and response
to changes in a patients condition.
o 16A: The organization selects a suitable
method that enables health care staff
members to directly request additional
assistance from a specially trained
individual(s) when the patients condition
appears to be worsening

WHY Rapid Response

Team Training?
IHI: Institute for Healthcare
Improvement
100,000 Lives Campaign
Introduces proven best practices to extend or
save as many as 100,000 lives by reducing
morbidity and mortality
Activating a Rapid Response Team is one of six
strategies to prevent avoidable deaths
Deploy Rapid Response Teamsat the
first sign of patient decline

WHAT is an Initial
Responder?
Wikipedia
Initial or First Responder is a term used
to describe the first medically-trained
responder to arrive on scene of an emergency
The first stage of being a first responder is
being able to recognize what it is that you are
required to know and perform the necessary
interventions

WHY Initial Responder

training?

Critical Incidents:

High percentage outside critical care areas

Survival highly dependent on Initial or First
Responders
Multiple factors influencing outcomes include:
Patient co-morbidities and initial cardiac rhythm
Duration of incident and time to defibrillation
Need for rapid and effective BLS and ACLS

WHY Initial Responder

training?
Importance for sufficiently trained personnel
Perform effective BLS
Initiate early intervention and defibrillation if
needed
AED utilization
Less intimidating
Support rapid defibrillation

WHY Initial Responder

training?
On average, greater than 9 minutes to
shock patient
Less than 10% of patients are provided proper
BVM ventilation
40% of nurses did not know the correct phone
number to activate the Rapid Response Team
Patient report was inconsistent
80% of nurses did not set the defibrillator to
the appropriate mode

How do you run

scenarios?
1. On the fly
2. Programmed but
always tweaking
3. Preprogrammed

*may select more than one answer

How do you debrief?

1.
2.
3.
4.

Record video
Use checklists
Collect data
Utilize Laerdal software
and hardware
5. Other

*may select more than one answer

Simulation Scenario
3 volunteers needed
3-5 minute scenario
Observers - please take notes to debrief as
you would normally at your organization
Volunteer scenario orientation
Setting
Equipment
Roles

Patient Report
Location: Non-Monitored Bed Unit
Patient: William Roberts
Patient Information: 82 year old
male post-operative for hernia repair
Past Medical History: Myocardial
Infarction
(4 years ago)
Meds: Aspirin daily

Debriefing Exercise
Share 1-2 of your debriefing points
Compare and contrast debriefing
points

Problem with current

debriefing methods (pick
your greatest pain)
1. Too many instructors
debriefing differently
2. Ineffective
assessment tools
3. Lack of standard
debriefing points
4. Inconsistent scenario
progression

Scoring Tools Exercise

Think back to the scenarioconsider
the following:
Would these tools have helped with the
assessment?
Do you feel the tools would help relate the
debriefing to scenario objectives?
Would these tools provide standardization to
the instructor community?
Is it important to assess the same way with
each training session?

Scoring Tools Exercise

Standard assessment tools help to

Keep instructors focused

Clearly outline learning objectives
Organize time driven interventions
Gather valid research data

These are all common problems in

simulation-based training today!

What is a Course?
COURSE

Before Class

During Class

After Class

Based on the above information,

please share your thoughts on what
would go into each category.

What is a course?
COURSE

Before Class

During Class

After Class

Participant content

Lecture

Assessments

Instructor content

Simulation
Debriefing

SimMedical
Located in Pittsburgh, Pennsylvania
A company of University of Pittsburgh
Medical Center (UPMC)
Shares the tools and operational best
practices established over the past 14
years at the University of Pittsburghs
Peter M. Winter Institute for Simulation,
Education and Research (WISER)
WISER is a state-of-the-art simulation training
and research facility serving the University of
Pittsburgh and UPMC

SimMedical
Delivering comprehensive, realistic and
effective simulation-based training is at the
core of the SimMedical mission
Established track record of serving regional,
national, and international clients
Services include:

Simulation-based curricula / courseware

Consulting
Training
Web-based simulation information management
system (SIMS)

Partnerships
SimMedical, in partnership with Laerdal
Medical, is pioneering simulation-based
education
Joint venture offers curricula / courseware that
is:
Developed by board-certified clinicians and other
content experts
Designed with simulation educational methodology
that incorporates healthcare best practices
Created with a variety of learning techniques to
maximize retention of material

What is SimMedicals
The First 5 Minutes
Course?
All the materials needed to deliver a robust
simulation course

Course Goals:
Early recognition of critically ill hospital patients
before the code team arrives promoting improved
outcomes
Establish standardized behaviors for the initial
hospital responders

Target Audience:
Healthcare staff that are the initial responders to a
patient in crisis such as non-critical care nursing staff,
nursing students, respiratory therapists,
physical/occupational therapists, et al.

What is SimMedicals
The First 5 Minutes
Course?

Why?

Floor nurses and other hospital staff are

undertrained or are not trained to deal
with patients in crisis
Teaches staff how to manage patients in
crisis prior to the actual code teams
arrival
Part of a hospital quality patient safety
program
Meets regulatory requirements

What is SimMedicals
Rapid Response Team
Training Course?
Simulation-based educational training program
Course Goals:
Develop critical team building skills
Improve communication
Promotes efficient teamwork

Target Audience:
Clinicians who are part of the actual code team
that take over from the initial hospital responders
Roles include physician, nurse, pharmacist, and
respiratory therapist

What is SimMedicals
Rapid Response Team
Training Course?

Why?

Promotes the fundamentals of teamwork

Emphasis on communication
Strong focus on the importance of practice
Part of a hospital quality patient safety program
Meets regulatory requirements
Developed by Michael DeVita, MD
International leader in rapid response
systems and simulation training
Current President, Society for Simulation in
Healthcare

SimMedical Courseware
Solutions Focused

Courseware