The Impact of an In Situ Simulation Intervention on Interprofessional Collaboration during Critical Events.
CCCF ePoster library. Villemure C. Oct 28, 2015; 117318; P107
Catherine Villemure
Catherine Villemure
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Topic: Education Science

The Impact of an In Situ Simulation Intervention on Interprofessional Collaboration during Critical Events.

Catherine Villemure, L. Georgescu, I. Tanoubi, J. Dubé, J. Houle

Intensive Care Unit, CIUSSS-MCQ, Trois-Rivières, Canada | Anesthésie, Hôpital Maisonneuve-Rosemont, Montréal, Canada | Anesthésie, Hôpital Maisonneuve-Rosemont, Montréal, Canada | Soins Intensifs, CIUSSS-MCQ - Trois-Rivières, Trois-Rivières, Canada | Sciences Infirmières, Université du Québec à Trois-Rivières, Trois-Rivières, Canada

Introduction: Due to potentially life-threatening conditions and high risks of errors, critical care frequently requires a prompt team intervention. Effective communication and teamwork are central components of interprofessional collaboration (IPC) and miscommunication among professionals during crisis events management may directly affect the patient safety. Developing strategies to enhance IPC among critical care workers should be prioritized in critical care units. In Situ Simulation (ISS), the simulation used in the real clinical setting, can be particularly valuable to improve patient safety because it brings together the elements of the care team and the environment. However, its impact on IPC is still to demonstrate.

Objectives: The primary objective is to evaluate the impact of an ISS based training on self-assessed IPC during crisis events management among an interprofessional care team. The secondary outcome is the impact on professionals satisfaction towards their coworkers.

Methods: Quasi-experimental study, pretest and posttest design with a paired control group. A convenience sample (N=69) was recruited among the healthcare professionals of the regular PACU team of two university hospitals, including nurses, respiratory therapists, anesthesia residents and staff anesthesiologists. Thirty three participants were in experimental group and 36 were in control group. The intervention consists of a 6-hour simulation based team training, on the crisis resources management principles, given by simulation based medical education experts. Three scenarios were used, composed of typical deteriorating cases encountered in critical care settings, and followed by a debriefing period supported by the video recording of the simulation. The measured outcomes were IPC and professionals teamwork satisfaction, evaluated by the Collaborative Work Questionnaire (Cronbach alpha=0.85-0.93) and the Satisfaction Towards Coworkers Questionnaire (Cronbach alpha=0.91), both on a 7-points Likert scale. The Collaborative Work Questionnaire allows evaluating global IPC and 4 domains (communication, synchronicity, explicit and implicit coordination).Questionnaires were answered at 3 periods of time: before the intervention (T1), immediately after (T2), and 6 to 8 weeks later (T3).

Results: Baseline demographic characteristics were similar in both groups. Global IPC was significantly increased in the experimental group from T1 to T3 (means 4.41±0.76 vs 4.85±0.88; p=0.018), whereas no difference was observed in the control group (means 5.19±0.79 vs 5.19±0.89; p=0.359). Linear mixed model indicates that the change in global IPC was different between groups (F2,67=3,88; p=0,025). Also, an improvement of explicit coordination was observed from T1 to T3 in the experimental group (means 3.75±0.96 vs 4.54±1.14; p<0.001), but not in the control group (means 4.44±0.92 vs 4.68±1.11; p=0.054). The interaction effect (group x time) for communication was different between groups (F2,67=4.09; p=0.021). Changes in other domains of IPC were not different between groups (p>0.05). Satisfaction towards coworkers was high and similar in both groups at baseline (means 5.95±0.53 and 5.75±0.98; p=0.287). The intervention had no significant impact on this variable.

Conclusion: An ISS based team training had a significant impact on self-assessed IPC during crisis events management in our study. The use of ISS should be promoted among critical care teams, in order to teach communication skills and enhance IPC contributing to patient safety.

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