Lights, Camera, Action: Implementation of In-Situ Drills in the Perinatal Setting
Article first published online: 14 JUN 2012
© 2012 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses
Journal of Obstetric, Gynecologic, & Neonatal Nursing
Special Issue: 2012 Convention Proceedings
Volume 41, Issue s1, pages S100–S101, June 2012
How to Cite
Renfro, C. and Zambrana, L. (2012), Lights, Camera, Action: Implementation of In-Situ Drills in the Perinatal Setting. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 41: S100–S101. doi: 10.1111/j.1552-6909.2012.01361_70.x
- Issue published online: 14 JUN 2012
- Article first published online: 14 JUN 2012
- in situ;
Purpose for the Program
The multidisciplinary simulation team at Baylor University Medical Center sought to expand training beyond the simulation lab and into the clinical setting to achieve a multidisciplinary, multiunit team approach. This would allow them to identify gaps in communication and process issues and, therefore, implement change before any harm was done to a patient.
To evaluate clinical skills, communication, and processes on the units, the simulation team chose to implement in situ simulation drills in an effort to capture real-world experiences and evaluate the multidisciplinary team's performance.
Implementation, Outcomes, and Evaluation
To effectively plan and operationalize the in situ simulation drills, the team devised high-risk, low-volume scenarios based on the input from the unit educators, risk management, and patient safety. The staff on the units were unaware of the upcoming drill to fully capture their knowledge, skills, and communication patterns in these high-stress scenarios. Video recording captured the scenario as it unfolded and appropriate high- and low-fidelity simulators were used to mimic the most realistic scenario possible. Immediately following the scenario, the staff debriefed the video recorded event. In the facilitated debriefing, the participants were able to recognize gaps in communication, identify errors in clinical skills, acknowledge teamwork deficiencies, ascertain the need for a leader, as well as identify process issues that required immediate change. One of the common themes discussed in the debriefing was the need to implement more effective communication as well as the need to establish a common language to help bridge the gap in understanding spoken terminology to ultimately optimize patient safety.
Implications for Nursing Practice
In situ drills allow for a more accurate evaluation of knowledge, clinical skills, and behavioral skills among the health care team, especially in relation to gaps in communication that can lead to the increased risk for errors or near misses. Facilitated video recorded debriefing allows participants to recognize gaps in performance. Utilizing simulation for in situ drills creates a safer environment for the patient especially in these high-risk, low-volume situations.