Cardon Children’s PICU – Low Volume/High Risk Skill – Previous experience – Patients transferred to other facilities – No continuity of patient care – Decreased RN confidence – Decreased MD confidence The education “fix” at the time – Training from company educators – Tech support from company – Practice – Support from adult ICU Legend: NE: no experience RMH: run machine with help RM: run machine without help ET: Basic training AT: Advanced training

Goals – Core group of PICU staff – Set-up and Troubleshoot 30 minute set up time Access Clotted Filter Initiation and Disconnect Improve confidence levels – Assist with future education & training Resources – Evidence-based education lacking for CRRT – Simulation shown to assist learners transition skills into practice

Logistics – Cost Schedules Equipment – Develop curriculum Weighted Checklists Eight hour didactic session Three 4-hour based simulations Mandatory monthly 4-hour simulation session – Simulation Use of saline in simulation not satisfactory to replicate troubleshooting Develop tubing to accommodate blood Create scenarios

Remediation decreased as the skill level of the nurse increased Goal: less than 30 minutes Time to Set Up

Nursing self-confidence increased significantly Physician confidence increased significantly