The Science Journal of the American Association for Respiratory Care

2008 OPEN FORUM Abstracts


Patricia A. Achuff1, Kathleen Monforto2, Roberta L. Hales3, Marlene Hamilton1

Background: Stressful acute situations requiring skills not often used may cause multidisciplinary teams to be nervous, anxious, and unsure of resources resulting in delay of patient treatment. Active learning using high fidelity simulation can be used to familiarize staff with resources and equipment, increase knowledge, improve technical skills, and build teamwork.

A pilot program simulating pediatric severe status asthmaticus requiring Magnesium Sulfate administration was trialed on one General Pediatrics Unit. One scenario programmed into a Laerdal MegaCode Kid simulator was run with multidisciplinary staff teams after discipline specific learning objectives were established. Qualified observers completed separate checklists, including technical and behavioral skills, for physicians, nurses, and respiratory therapists. Teams were debriefed after scenarios. All participants completed a Likert-scale evaluation form rating how well they were able to meet the simulation objectives. Analysis included mean and standard deviation.

Thirty five staff participated over a 3-week period: 11 respiratory therapists, 5 physicians, and 19 nurses. On a Likert scale of 1-5, nurses and respiratory therapists evaluated the simulation training as very good (score 4) in meeting the objectives of recognizing signs/symptoms of respiratory distress (mean 4.57, SD 0.50), collaborating with the multidisciplinary team (mean 4.43, SD 0.63), appropriateness of teaching strategies (mean 4.63, SD 0.49), and collaborative documentation (mean 4.03, SD 1.22). Nurses also evaluated the simulation as very good for meeting the following objectives relating to Magnesium Sulfate administration: locating dose and administration guidelines (mean 4.17, SD 1.04), determining the correct dose (mean 4.44, SD 0.62), identifying the equipment needed for administration (mean 4.68, SD 0.48), identifying adverse reactions (mean 4.26, SD 1.05), describing patient monitoring guidelines (mean 4.58, SD 0.61), and identifying available resources for the staff nurse administering magnesium sulfate (mean 4.53, SD 0.84). No physicians participated in the program evaluation.

High fidelity simulation is an effective teaching method and collaboration builder for the multidisciplinary team. Simulation enhanced nursing and respiratory therapist knowledge, skills, and familiarity of resources.