Prince William and his new bride made headlines when they used a defibrillator to revive a human patient simulator (HPS) at the 21st Century Research and Innovation Centre in Calgary, Alberta on their recent trip to Canada.While you don’t expect to see the royal couple in such a context, simulators are also beginning to be seen in new places. Holy Cross Hospital in Fort Lauderdale is using the teaching tool normally found in nursing schools to develop skills, update skills and evaluate competency among nurses.
Simulator use has become increasingly prominent in highly complex work environments where the consequences of error are costly. The HPS is to the nurse what a flight simulator is to a pilot. As technology advances, simulations have become more realistic to offer a high fidelity instrument providing a realistic clinical environment with an interactive “patient.”
Many hospitals and nursing schools find that simulation training is effective and also increases positive patient outcomes. This is in no small part due to its ability to replicate a real-life emergency. By creating a realistic environment, simulation allows nurses to practice techniques as well as learn to communicate better under stress, instill teamwork and manage human reaction in the heat of the moment.
In a study published in Computers Informatics Nursing in January 2010, V.M. Howard et al. tested the educational impact of HPS versus interactive case studies among students from baccalaureate, accelerated baccalaureate, and diploma nursing programs. Students in the HPS group scored significantly higher on the examinations after the experience than did the interactive case study group.
Our experience with HPS at Holy Cross began in 2007 when we borrowed a simulation from Broward College and ran a "code blue day" in an empty patient room. The response was so positive that Holy Cross Medical Group purchased a HPS which now resides in a room dedicated to running simulations.
The Laerdal SimMan® has pre-programmed patient responses with the ability to add more. At Holy Cross, we are currently utilizing the HPS to mimic code blue and code rescues. In addition to increasing a nurse’s comfort level when facing his or her first code blue, our goal is for all of our nurses to recognize the signs of a declining patient and to support critical care nurses called to respond to code blue alerts outside their areas.
We have replaced the didactic module of the nurse residency program with a four-hour simulation that runs our nurses through code blues and code recues to define their roles, expectations and the health care they should provide. The simulation lab is also open to night shift nurses, those most likely to experience these codes, from midnight to 4 a.m. at scheduled times throughout the year. Plans for the future are to increase the use of simulation to develop and implement evidence based practice as it relates to the diagnosis, treatment and prognosis of critically ill patients.
