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.

Peter Mallett

Clinical Fellow in Simulation & Education
Dept of Paediatric Simulation & Education

Hi my name is Peter Mallett.
I am a Paediatric Registrar in Northern Ireland. I gradtuated from Queens University Belfast in 2010.
I am currently doing a fellowship in Education & Simulation in Royal Belfast Hospital for Sick Children.
My interests include Technology enhanced learning, translational simulation, human factors ,Quality improvement & Sim-based inter-professional education.


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Barbara Maxwell

Paediatric Respiratory Specialist Nurse


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Ruth Harte

Paediatric Respiratory Specialist Nurse


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Niamh Galway

Paediatric Respiratory Registrar


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Dara O Donoghue

Clinical Academic Consultant Paediatrician


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Peter Weinstock, MD, PhD

Director - Simulator Program
Boston Children's Hospital, MA

Chair and Executive Director, Boston Children's Hospital Simulator Program (SIMPeds)
Senior Assoc. Critical Care Medicine
Associate Professor of Anesthesia, Harvard Medical School

A practicing pediatric intensive care unit physician, Dr. Weinstock combines >20 years in surgery, medicine, education and innovation to lead the Boston Children's Simulator Program (SIMPeds) to one of largest most integrated "return on investment" simulator enterprises world-wide. Dr. Weinstock has weaved sustainable medical simulation ecosystems into the fabric of medical centers and regional health care systems on 6 continents and is founding president of the International Pediatric Simulation Society (IPSS). He serves on multiple advisory boards including education, simulation, social robotics and AI, and lectures internationally including "TED" on combining simulation, human factors, 3DP and special effects -- all to prepare world-class clinicians and healthcare systems to perform at their best, as well as to reduce fear and anxiety in patients and families.


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Using Simulation based Interprofessional Education to introduce Ward-level High Flow Oxygen care in Bronchiolitis

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