1. NuNeoSIM Survey - A Triple Blind Study of Nursing Perception to Simulation Training in a Tertiary Neonatal Intensive Care Setting
Ball J1,2 , Gunda R1,2 ,Adejumoke A1,2, Sharma A1,2
1 University Hospital Southampton 2 MPROvE Group
Background
“The unfamiliar was familiar because it had been encountered many times before.”
Simulation was endorsed by the Chief Medical Officer, Department of Health in using this statement.
It was subsequently endorsed by the National Patient Safety Agency as a valuable tool for training the medical workforce in the UK to address patient safety issues. 2
Multidisciplinary simulation in neonatology increases participant's confidence in neonatal emergencies3 and may improve patient outcome. 4
Southampton Neonatal Simulation Programme
Simulation was piloted as a medical programme without curriculum mapping in Feedback from the initial pilot (2011) showed that 99% of participants thought the sessions were relevant to their practice and 99% thought the sessions were of high quality.
Multiprofessional neonatal simulation programme was established in our unit in  Initial feedback in 2012 has shown that the majority of participants agreed that the sessions conducted were of high quality (92%), simulation was relevant to their training (97%) and that it should be part of their training (92%). Closer scrutiny of the feedback from nurses and doctors separately has been an eye opener. Nurses were less likely to strongly agree that sessions were relevant to their training (62 vs 86%), scenarios were relevant to their clinical practice (59 vs 92%) and that post scenario multi professional feedback was relevant and useful (60 vs 84%). We have also struggled with adhoc nursing participation and take up by nursing colleagues.
Methodology
After approval from local research and development department we have performed a double blind cross sectional questionnaire study to explore the nursing perception to simulation training. An initial survey was completed in May 2013 followed by curriculum mapping and incorporation of nursing facilitators. A repeat survey is to be conducted in June Questions included whether nurses had participated in simulation, no of sessions, their perceptions towards simulation, whether it had changed their practice, how it should be run and whether it should be run separate to the doctors.
Potential Impact
The results show that less than 50% of nurses had uptake in the programme in Nursing participants thought simulation was daunting, it made them anxious and they perceived it as a test. A constant theme was being watched by their peers. Despite their concerns 88% of nurses said no to doing simulation separately do the doctors. Reasons provided are in the section on free comments. Since this survey we have implemented changes which include having multidisciplinary facilitators (1 doctor and 1 nurse for each session); training of nurse facilitators; curriculum mapping of scenarios to the BAPM QIS competencies for neonatal nursing and RCPCH curriculum for paediatric trainees and a quality matrix. This was implemented in A repeat survey of the nursing staff is currently underway to assess uptake and perception 18 months after implementation.
Themes from survey
Word cloud showing 11 most important words and phrases used in the survey (the size according the frequency)
Survey Results 2013 (93 Responses)
References: 1. National Patient Safety Agency-NPSA. Review of patient safety for children and young people (June 2009). NPSA Website Accessed October 13, 2012
Donaldson L: Safer medical practice: machines, manikins and polo mints, 150 Years of the Annual Report of the Chief Medical Officer: On the State of the Public Health Edited by Donaldson L. London, Department of Health, 2009, pp 49-55
Davidson, S., K. Hassell, et al. (2014). "PC.82 Neonatal Simulation Training Improves Paediatric Trainees’ confidence in Emergency Scenarios." Archives of Disease in Childhood - Fetal and Neonatal Edition 99(Suppl 1): A64
Sharma, A. and R. Gunda (2014). "PB.11 Cascading Risk Through Multiprofessional Neonatal Simulation." Archives of Disease in Childhood - Fetal and Neonatal Edition 99(Suppl 1): A35-A36