Purpose for the Program
Evidence has shown how simulation is an effective modality of teaching especially for adult learners. In a perinatal unit, where the level of nurse experience ranges from 1 to 30 years, the focus should not only be to determine the nurses’ skills and readiness to respond during a crisis but also on the ability of the nurses to be great team players and practice effective communication. Simulation, even on a low budget, would still help nurses prepare for high-risk rare events with an ultimate goal of a healthy mother and infant.
To improve patient outcomes through evidence-based practice following a standardized process in an obstetric (OB) emergency or neonatal complication after birth. The proposed changes included role-specific functions and responses, initiating the chain of communication, improving teamwork, redesigning unit practice, and regular multidisciplinary simulations.
Implementation, Outcomes, and Evaluation
The first step was to send out an online questionnaire regarding simulation and high-risk rare events to evaluate what the nurses’ current view of such topics and to see if they were willing to participate in a simulation. The next step was to create a calendar of dates and times to make the nurses want to participate with simulations. The schedule was one scenario per shift. Low-fidelity simulators and/or volunteers were used to make the simulations more realistic. Debriefing, through the evaluation of the recorded event, took place after the simulations were completed. It was then decided by the OB advisory that debriefings should be done on all OB procedures that were completed in our unit. In addition, protocols were revised and updated. New protocols were incorporated in our electronic medical record that also prompts documentation.
Implications for Nursing Practice
Staff's perception of simulation has changed from a negative outlook to a positive outlook. They are aware that the environment of a simulation is safe and mistakes are allowed so that during a real event staff may be prepared and ready.
Staff readiness was improved by using simulation to define the process, educate, assess competency, and improve teamwork and communication. The use of simulation for ongoing team evaluation will continue to reinforce these skills so that if a complication does occur this multidisciplinary team will be prepared to ensure the most optimal outcome. We are on our journey toward excellence in our nursing practice.