The following is a summary of “Pragmatic Approach to In Situ Simulation to Identify Latent Safety Threats Before Moving to a Newly Built ICU,” published in the July 2024 issue of Critical Care by Sarwal et al.
Moving patients between care settings can introduce unforeseen risks requiring close attention to ensure patients’ well-being.
Researchers conducted a retrospective study leveraging in situ simulation to familiarize staff with the new adult ICU layout and identify potential safety hazards before patient admission.
They conducted a descriptive analysis of a patient safety initiative implemented in a newly constructed 24-bed neurocritical care unit within a tertiary care academic medical center. The study focused on care providers operating within the neurocritical care unit. A three-part in situ simulation program was designed to prepare staff for the transition from an open-bay unit to a new private-room ICU. Standardized patients and mannequins were used to simulate scenarios, with all electronic databases involved in creating “test” patients. Staff from both clinical and non-clinical areas participated in or observed the simulations. Debriefings after each stage identified safety threats and concerns, further supplemented by surveys sent to all participants. The monitoring was continued for missed safety issues for two years after the transition, addressing any problems.
The result showed that 70 safety threats were identified and mitigated, encompassing concerns related to physical environment, infection control, patient workflow, and informatics prior to the relocation to the new unit. An orientation manual was created, emphasizing new ICU features and best practices derived from simulations, with all participants strongly agreeing on the benefits of the simulations. A 2 year follow-up was also performed, revealing only 2 missed latent safety threats.
Investigators concluded that in situ simulation effectively identifies latent safety threats associated with transitioning to new ICUs, warranting consideration prior to unit relocation.
Source: journals.lww.com/ccmjournal/abstract/2024/07000/pragmatic_approach_to_in_situ_simulation_to.27.aspx