Traditional Poster Round
Using Simulation based Interprofessional Education to introduce Ward-level High Flow Oxygen care in Bronchiolitis
Tuesday, May 15
09:45 - 10:45
Location: The Gate, Atrium Level
Context: : Acute Bronchiolitis is the most common respiratory condition in infants under one year of life. In the UK, approximately 1 in 3 infants will develop Bronchiolitis in the first year of life and ~2-3% of all infants require hospitalisation.1
In severe cases, management often involves transfer to Paediatric Intensive Care for ventilation and supportive care. This has significant workload and resource implications for many PICU centres.
Recent studies suggest that, whilst the use of High Flow Nasal Cannula Oxygen (HFNCO) does not modify the underlying process in cases of moderately severe bronchiolitis, it may have a role as rescue therapy to reduce the proportion of children requiring High-cost intensive care.2
Previously, in Royal Belfast Hospital for Sick Children (RBHSC), Northern Ireland’s Tertiary Level Paediatric Hospital, the medical ward did not have the resources available for managing patients with Bronchiolitis requiring HFNCO.
Following a coordinated multi-professional strategic approach within the hospital, provision has been made to facilitate initially one High-Flow unit in the ward over winter 2017. This presents issues for nursing and medical staff requiring training and support for this new service.
Description: : The Paediatric Respiratory and Simulation Education departments designed and co-ordinated various Inter-professional Staff Education sessions to train medical and nursing staff as well as healthcare assistants .
The sessions were led by Clinical Education Fellow and Paediatric Specialist Respiratory nurse with support from Consultants in Paediatric Respiratory Medicine and Acute Medicine. A brief introductory lecture was followed by a practical demonstration and interactive session, and finished with a Simulated Learning Event reflecting on new knowledge. Participants completed a questionnaire following the training sessions to collect both quantitative and qualitative data on the educational experience.
Observation/Evaluation: : 33 staff members received HFNCO teaching – 14 medics (10 Trainees, 4 Consultants), 1 Advanced Paediatric Nurse Practitioner, 15 Nurses and 3 Healthcare assistants.
95% (31/33) of staff felt significantly more confident in approaching HFNCO following the session, with 100% feeling that the session would be useful for their day jobs, and 100% concurring that practical use and demonstration in Simulated environment helped improve their practical skills and improved confidence. Comments included ‘Really enjoyed practical experience of handling equipment in session’, and 'Excellent nursing and medic teaching session. Please use this as a tool for future teaching on different topics'.
Discussion: : The introduction of any new service to a Hospital unit can be a challenging and arduous journey. Staff members can often feel anxious with regards to pre-existing service demands, lack of theoretical knowledge or lack of familiarity with procedural skills (e.g. setting up equipment) , and thus successful implementation can be met with many barriers.
Simulation training, combined with an interactive training session, has been suggested to be a ‘useful tool for improving procedural competence and decreasing anxiety levels, particularly among those at an earlier stage of training’.3
This locally-novel concept has been shown to be an extremely effective educational tool in this hospital, has improved procedural exposure and enhanced staff perceptions. It will hopefully aid and embed successful service provision, in a bid to promote improving patient care.
Clinical Fellow in Simulation & Education
Dept of Paediatric Simulation & Education
Paediatric Respiratory Specialist Nurse
Clinical Academic Consultant Paediatrician
Consultant Paediatrician and Lead Educational Supervisor
Royal Belfast Hospital for Sick Children, United Kingdom