Traditional Poster Round

Poster

Paediatric Sepsis Simulation

Tuesday, May 15
09:45 - 10:45
Location: The Gate, Atrium Level

Abstract : Paediatric Sepsis Simulation Half Day

Background:
Sepsis is an important cause of death in people of all ages. It has been identified as the leading cause of preventable deaths. Sepsis is difficult to diagnose with certainty as the signs and symptoms can be very non-specific. To reduce avoidable deaths, people with sepsis need to be recognised early and treatment initiated.

Research shows that failure to recognise and treat patients whose condition is deteriorating is a cause of significant unintended harm in healthcare environments. There are multi-factorial reasons why deterioration in children is missed but they can be clustered into themes:
• systems failure
• not responding to physiological changes (recognising and responding to deterioration)
• parent and carer engagement (and working in partnership with patients and their families)
• healthcare professionals training and education
The Proposal:
We aimed to meet the RCPCH and NICE (national Institute of clinical excellence) standards for staff education and training in relation to sepsis and recognition of deterioration in a sick child through the use of full immersion simulation.

Staff attending the study day were sent pre- course reading and we start the course with a brief introduction / orientation talk discussing the important factors in identifying and treating sepsis on the day. We run 3 simulation scenarios based on 3 different presentations of sepsis. The scenarios have been designed to look at different aspects of managing a child with sepsis:
-Identification of the sick patient - emphasis on PEWS, ABCDE assessment
-Recognition of sepsis and septic shock –discussion of the signs and symptoms
- Escalation of treatment – how to get help- the process and knowing the right people to call, use of inotropes, choice of antibiotics
- Referral to other specialties/ seniors- SBAR communication, effective handover
- Team working & communication - how to raise concerns, how to deal with difficult team members
There is an emphasis on human factors training and participants are encouraged to share their own experiences to allow attendees to relate their learning to everyday work on the wards.
After completing the study day candidates reported increased confidence in their non-clinical skills. All participants reported that they felt the simulation sessions were very useful in allowing them to participate in managing a sick patient.
We have used full immersion simulation as part of a multi-pronged approach to improve the recognition and management of sepsis in accordance with national guidelines. By implementing this training as part of the multidisciplinary education program we have improved staff awareness of sepsis and the escalation pathways within the paediatric wards.
We would like to further evaluate the long term benefits of the simulation program and whether there is a measurable improvement in patient safety and to implement feedback programmes that allow participants to be contacted at varying times after attending the course to assess impact of the training on their day to day work.





Nabila N. Burney

Senior Clinical Fellow, Paediatric Emergency Medicine
Chelsea and Westminster Hospital
London, England, United Kingdom

Dr Nabila Burney and Dr Poonam Patel are Paediatric Emergency Medicine Fellows at Chelsea and Westminster Hospital in London. They run regular in in-situ and high fidelity full immersion simulation training for undergraduate and postgraduate doctors and nurses. They have developed and run a sepsis training simulation course and are involved in creating a ketamine sedation training programme involving simulation training.

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James Ross

Paediatric Emergency Medicine Consultant
Chelsea and Westminster

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Poonam Patel

Paediatric Specialist Trainee (SpR)
Chelsea and Westminster Hospital

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Lennox Huang, MD

Chief Medical Officer, VP Medical & Academic Affairs
The Hospital for Sick Children, ON, Canada

Dr. Lennox Huang is the Chief Medical Officer and Vice President for Medical and Academic Affairs at the Hospital for Sick Children in Toronto, Canada. He is a staff physician in the Pediatric Critical Care Unit at Sick Kids and holds the rank of Associate Professor in the Department of Paediatrics at the University of Toronto and Associate Clinical Professor of Pediatrics at McMaster University.

Dr. Huang’s past leadership roles include Chair of the Department of Pediatrics at McMaster University and the Chief of Pediatrics at Hamilton Health Sciences and St. Joseph's Healthcare Hamilton. Dr. Huang has held leadership roles at the regional, provincial and national level including President of the Regional Medical Associates of Hamilton, and Vice President of the Paediatric Chairs of Canada.

Dr. Huang’s interests are in the areas of simulation, patient safety, and quality improvement. He has led projects using Lean principles and in-situ simulation to guide the design and testing of clinical spaces and has incorporated simulation into hospital-wide safety initiatives.

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