The Science Journal of the American Association for Respiratory Care

2007 OPEN FORUM Abstracts

THE DEVELOPMENT OF A HIGH FIDELLITY SIMULATION MODEL OF SURFACTANT ADMINISTRATION: INTEGRATION OF A SKILLS TRAINER WITHIN A WHOLE BODY INFANT SIMULATOR

R. Jackvony1, B. Grenier1, G. Hayes1, P. Weinstock1

Background: Administration of exogenous surfactant to the critically ill neonate remains a mainstay in the treatment of RDS. Despite its widely accepted use, surfactant administration (SA) may be considered a high-risk, low frequency procedure in some NICUs. In order to provide a risk-free training environment and ensure competency in the procedure in our institution, we developed and validated a high fidelity simulation model of SA.

Methods: A whole-body infant simulator was modified to allow for the administration of a surfactant-like substance, the control of reflux during administration, and changes in cardio-pulmonary physiology based on therapist interaction. Senior respiratory therapists experienced in precepting and assessing competency in the NICU evaluated the SA model. Following an orientation to the simulation environment, each therapist independently performed the SA procedure then completed a questionnaire rating (1) the realism of the simulation environment, (2) tactile components of the model, and (3) the physiological response of the simulator. In addition, they were asked to identify potential applications of the SA trainer. All responses were based on a 5 point Likert scale.

Results: Seven senior respiratory therapists completed the questionnaire (mean years of NICU experience = 17). Fifteen questionnaire items were grouped into five categories.

Conclusion: A realistic surfactant administration model can be built within available whole body infant simulators. This high fidelity simulation model of SA provides the opportunity for safe practice and competency assessment among a range of expertise.

Evaluation Categories Mean (SD)
1-Strongly Disagree
5-Strongly Agree
The simulation environment and scenario were realistic. 4.9 (0.22)
The tactile components (surfactant preparation, instillation and physical attributes of the manikin) were realistic. 4.7 (0.48)
The manikin's physiological response to instillation and therapist intervention was realistic. 4.5 (o.68)
This SA model can be effectively used to instruct and evaluate new therapists. 4.8 (0.43)
This SA model can be effectively used to evaluate the competency of veteran respiratory therapists. 4.7 (0.49)



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