The Science Journal of the American Association for Respiratory Care

2006 OPEN FORUM Abstracts

Impact of a Virtual Education and Simulation Technology (VEST) Lab on Respiratory Care Practitioner Intubation Performance with Patients

Francis Gott III, AS, RRT; John Emberger, BS, RRT; Charles Fort, RN, MSN, Departments of Respiratory Care and Academic Affairs, Christiana Care Health System, Newark DE.

Background: Respiratory Care Practitioners (RCPs) at Christiana Care Health System (CCHS) maintain certification as part of our intubation team. RCPs are the first line intubators at code and emergent situations. CCHS has two facilities: one with 24 hour anesthesia staff coverage (facility 1) and another (facility 2) with less than 24 hour anesthesia staff coverage. The RCPs who work in facility 2 are called to intubate patients with difficult airways more frequently than RCPs in facility 1. RCPs that work in facility 2 were selected to attend a Virtual Education and Simulation Technology (VEST) lab session using a METI Human Patient Simulator. A VEST lab session with nine difficult airway scenarios was incorporated into RCPs (at facility 2) training to help maintain and/or improve intubation skills.  The current study was designed to evaluate the effectiveness of simulation lab training on intubation performance. 

Method:
We examined two years (2005-2006) of our department intubation log of actual patient intubations. We collected all successful and failed intubations of the RCPs who attended the VEST lab session, as well as RCPs who did not attend a VEST lab session. 

Results:
Fourteen RCPs attended the VEST lab session. Eighty intubations were identified as performed by RCPs who attended the VEST lab session. Thirty-five were pre-VEST lab and forty-five were post-VEST lab.  One hundred thirty-six intubations were identified as performed by RCPs who did not attend the VEST lab (non-VEST Lab RCPs). The table shows the success rates of intubations.

  # Failed Intubations # successful Intubations % Attempts Successful
Non-VEST Lab RCPs 17 119 88%
RCPs Pre-VEST Lab 6 29 83%
RCPs Post-VEST Lab 4 41 91%
                        Overall 27 189 88%

Conclusions:  The success rate of the RCPs improved after attending the VEST lab (83% pre versus 91% post).  The RCPs chosen to attend the VEST lab may have attempted more difficult intubations because they are in a facility without 24 hour anesthesia coverage. This would explain the initial success rate of 83% as opposed to the initial 88% success rate of non-VEST lab RCPs. Using VEST lab sessions for intubation and difficult airway training may be a valuable way to improve and maintain intubation skills.

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