Making Interdisciplinary Education a Priority

This year, the Advanced Practice Nurses at Holy Cross Hospital in Fort Lauderdale launched an initiative committing to interdisciplinary education. In addition to offering quality and safety education, interdisciplinary programs build teamwork and collaboration.

 

Four interdisciplinary initiatives were determined to be educational priorities at Holy Cross Hospital for 2012. In designing the four programs, we felt a common factor should be the use of our human patient simulator. The "SimMan 3G" manikin enables us to run lifelike complex patient scenarios in which each member of the healthcare team practices important care interventions. The manikin has numerous capabilities, including breathing, speaking, generating multiple cardiac rhythms and heart, lung and bowel sounds. Scenarios can be recorded for review during post-simulation debriefings. This practice encourages the development of effective and synergistic team work with the ultimate goal of optimizing response times and patient outcomes.

 

The first three initiatives described are currently underway and the fourth is planned to begin later this year.

 

A review of our data determined that one of the most common reasons for calling a rapid response is because of a narcotic induced respiratory event. In this scenario, the manikin “patient” is recovering from a hip replacement and has a patient controlled analgesia pump in use for pain management. A crash cart, monitor/defibrillator, oxygen delivery devices and medications are located nearby.

 

Nurse residents and medical students work together in this simulation which begins when a patient care tech can’t wake the patient. The scenario continues as the primary nurse arrives and initiates a “Code Rescue” to summon the physician and the emergency team.

 

At the completion of the simulation, an Intensivist leads an interactive debriefing. Participants sharpen their communication skills and learn to communicate pertinent facts needed to bring about a successful outcome in a life-threatening situation.

 

Being a Stroke Center of Excellence, Holy Cross Hospital rapidly assesses patients who arrive experiencing symptoms of a stroke to determine if they meet the criteria for numerous treatment options, including interventional procedures or an IV medication to dissolve the clot.

 

Many points of care offer dangers of delay and include getting the patient to the hospital, performing CT scans, drawing and running lab work and arranging an examination by a neurologist.

 

A perfect example of interdisciplinary education, this scenario includes nurses, pharmacists, CT scan technicians, laboratory technicians, and soon EMS responders from the community. Each discipline has pre-determined learning objectives that relate to their role in the care of a stroke patient. The manikin is admitted through the Emergency Department and the clock is ticking as the care team learns to work together.

 

In the fall, the simulation will move into the community with EMS responding to bring the manikin from an outside location. In addition, we are expanding this educational tool beyond the direct participants by filming each aspect of the manikin’s care for eventual viewing by the entire clinical staff.

 

Based upon an actual patient event, a 20-minute mobile critical care simulation was developed. We decided to recreate the event using the manikin and all of the actual equipment that was in use, including a ventilator, monitoring equipment and a tracheostomy. The simulation is being scheduled during all shifts in all critical care units until each nurse and respiratory therapist who care for ventilator-dependent patients with tracheostomies has participated.

 

There are many considerations that must be taken into account when caring for bariatric patients, including the possibility of adverse complications and the need for demonstrating weight-related cultural sensitivity.

 

A new scenario will initially be implemented with nurses and respiratory therapists and is being designed with input from a bariatric surgeon to include how to effectively communicate with the patient and how to respond to a post-op pulmonary embolism.

 

Holy Cross Hospital’s interdisciplinary simulation education programs deliver increased collaboration and support our commitment to optimal patient outcomes.