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Interprofessional Simulation Project to Improve Inpatient Care of Patients with Pulmonary Arterial Hypertension (PAH)

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Conference: 2015 PH Professional Network Symposium

Release Date: 09.17.2015

Presentation Type: Abstracts

File Download: 2015 Symposium Abstract - 1014

File Size: (241 kb)

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Purpose

The objective of this project was to assess the effectiveness of interprofessional education utilizing clinical simulation for instruction of nurses, physicians, and pharmacists who care for inpatients with PAH.

Background

The inpatient care of patients with pulmonary arterial hypertension is challenging. Optimal care requires open communication among a multidisciplinary team that includes nurses, pharmacists, and physicians. Additional complexity is introduced if therapy includes infused medications. Reflecting this complexity, a survey of leading PAH Centers has documented associated errors in PAH care delivery. Training healthcare professionals in a simulation environment is especially valuable for situations which, as for PAH, are relatively uncommon and complex.

Methods

Competencies for healthcare workers who care for PAH patients were identified and simulation training was designed to teach and assess participants’ skill in those competencies. The scenarios included: initiation of intravenous epoprostenol, transition from intravenous epoprostenol to subcutaneous treprostinil, and transition from an infected line to a clean line requiring bedside determination of line volume and priming of the line with the correct volume of therapeutic infusate. The exercise utilized a training space in the electronic medical record (EMR) where patient charts were simulated to include order sets, medication lists, and nurse communications that were in use at the time in the hospital. The project was carried out in the Michael F. Sorrel Clinical Simulation Laboratory, a 7,750 square foot facility. The simulation room provided bedside access to the EMR and a Laeradal high-fidelity “SimMan 3G” simulator which provided visual and haptic feedback for respiratory and cardiovascular responses and case specific feedback operations to mirror a patient’s subjective reaction to medications and interventions.

Results

Simulation identified actionable areas for improvement that fell into several categories: improved clarity in the EMR, enhanced nurse training, and technical enhancements at the bedside. Post simulation evaluations of the participants demonstrated competency of all professional groups for the three scenarios. Summative evaluation of the simulation revealed that participants enjoyed the interactive, hands on learning; safe environment; and open communication with team members.

Conclusion

Interprofessional education using simulation contributes to team building and collaborative practice. Opportunities for improvements were identified and have been successfully integrated into clinical practice.