26 research outputs found
Lumbar puncture simulation in pediatric residency training: improving procedural competence and decreasing anxiety
Acceptance and effectiveness for learning of a simulation manikin for suprapubic aspiration in toddlers constructed with simple means
Impact of simulation‐based learning on immediate outcomes of temporary haemodialysis catheter placements by nephrology fellows
Recommended from our members
Sexual assault forensic examiners' training and assessment using simulation technology
More than 190,000 sexual assaults involving persons aged 12 years or older occur annually in the United States. For these victims, a forensic examination is the first step in the process to justice. Assessment and treatment of victims, as well as the meticulous collection and documentation of evidence, are vital for a strong case. Providing timely services 24/7 by qualified professionals can be taxing on schedules and budgets. Using in-house resources to cross-train ED personnel, we developed a program that introduced novice forensic examiners to common clinical scenarios encountered in the treatment of victims and provided a framework for the evaluation and management of each case.
Seventeen ED personnel attended statewide sexual assault nurse examination training and participated in four simulation scenarios and debriefings. Pre-tests and post-tests were administered, and a checklist was used to assess competence in performing examinations independently.
The majority of participants achieved competence (≥85% on the checklist) with their first case and had statistically significant gains in knowledge between pre-test and post-test (pre-test mean score [±SE] of 69.1 ± 1.7 vs. post-test mean score of 84.4 ± 2.6, P < .001). Course evaluations were favorable, with a mean score of 91.3%.
Our results validated the use of simulation technology and in-house resources for cross-training in a sexual assault forensic examination program, together with a checklist to assess competence in performing examinations independently. Benefits of having a sexual assault forensic examination program in the emergency department are standardized and timely care for victims, as well as enhanced evidence collection and increased reporting and prosecution of crimes
Recommended from our members
A blended approach to invasive bedside procedural instruction
This study assessed the impact of a blended, standardized curriculum for invasive bedside procedural training on medical knowledge and technical skills for Internal Medicine residents.The investigators developed a curriculum in procedural instruction and performance for Internal Medicine house staff, and implemented the program at a tertiary care academic medical center with a primary affiliation with a US medical school. The investigators chose procedures recommended for technical competence by the American Board of Internal Medicine: lumbar puncture, thoracentesis, paracentesis, central venous catheter insertion, and knee arthrocentesis. The program included: (1) assessment of baseline medical knowledge and technical proficiency on mannequins, (2) video instruction of procedure, (3) faculty-led discussion of critical concepts, (4) faculty demonstration of the procedure on mannequin, (5) individual practice on simulators, (6) post-intervention knowledge evaluation, and (7) post-intervention skills evaluation. The performance achieved during the initial skills evaluation on a mannequin was compared to the performance achieved on the first patient subsequent to the instructional portion.All participants with complete data demonstrated a statistically significant pre-intervention to post-intervention improvement (p < 0.05) in comprehensive medical knowledge and procedural skills.A blended, standardized curriculum in invasive bedside procedural instruction can significantly improve performance in participants' medical knowledge and technical skills
Effectiveness of stepwise interventions targeted to decrease central catheter-associated bloodstream infections
Recommended from our members
Systemic bevacizumab (Avastin) therapy for neovascular age-related macular degeneration : Twenty-four-week results of an uncontrolled open-label clinical study
Recommended from our members
The efficacy of visual cues to improve hand hygiene compliance
Guidelines governing healthcare workers' (HCW) hand hygiene (HH) behavior are well established. Despite known hazards of healthcare-associated infection to both HCW and patients, hand hygiene compliance (HHC) rates remain dismally low. To evaluate a potential solution to this ongoing challenge, we used a simulated patient encounter in an actual hospital room to test the efficacy of individual HH triggers.
One hundred fifty HCW (75 physicians and 75 nurses) participated in this study and were randomly assigned to one of five equal-size groups. Each participant performed a focused physical examination on a standardized patient and was expected to maintain HH before and after the examination. Using two rooms on a medical-surgical unit in a tertiary care teaching hospital, various cues were employed, and the impact on pre- and postexamination HHC was recorded. In the control group, the hand sanitizer dispenser was in its usual location (Baseline). In one group, the dispenser was relocated to direct line of sight (Line-of-Sight) on entering the room; in another, flashing lights were affixed to the dispenser in its usual location (Baseline & Flicker); and in a third group, the dispenser was relocated to the line of sight, and flashing lights were attached (Line-of-Sight & Flicker). In the last group, a large warning sign (Warning Sign) was affixed to the door, informing the healthcare provider that the room was under electronic surveillance, and failure to perform HHC would trigger an alarm. Data were analyzed using a generalized linear model to perform a repeated measures logistic regression; P<0.05 was considered statistically significant.
In the control group (Baseline), pre- and postexamination HHC rates were 36.7% and 33.3%, respectively. All interventions improved HHC preintervention compared with baseline (Line-of-Sight=53.3%, Baseline & Flicker=60%, Line-of-Sight & Flicker=66%, Warning Sign=93.3%), but only the Line-of-Sight & Flicker and the Warning Sign produced statistically significant increased pre-examination HHC (P=0.022 and P<0.001, respectively). Only the Warning Sign produced statistically significant increased HHC postexamination (P<0.001).
Visual cues can improve HHC, but their efficacy varies. A warning sign informing of a surveillance system with subsequent reporting of noncompliance resulted in the most significant improvement in HHC. Using a standardized patient in an actual hospital room was a helpful tool in assessing the impact of various interventions designed to improve HHC and patient safety