Traditional Poster Round
Background: : Simulation is a tool to improve patient safety, and in-situ simulation provides an authentic environment to develop team skills (1-4). However, limited attention has been given to challenges in providing family-centred care alongside simulation in clinical areas. The validated Simulated interPRofessional Team Training (SPRinT) programme delivers weekly in-situ simulation courses in a tertiary cardiorespiratory hospital, including in the paediatric intensive care unit (PICU) and paediatric wards, where parents are often at adjacent bedsides (5).
Research Question: : We hypothesised that parents of inpatients exposed to in-situ simulation could experience heightened anxiety and feel insecure about their child’s safety. We, therefore, sought to understand and explore parents’ perception of in-situ simulation.
Methodology: : Prospective, cross-sectional anonymous survey of parents of inpatients on SPRinT course days from January to September 2015. All present parents were informed that the simulation would be carried out using a mannequin, real teams and alarms, but that they were not real emergencies, as per usual practice. An information sheet and survey with demographic data and 14 statements using a 5-point Likert scale from “strongly disagree” to “strongly agree” were distributed prior to simulation. Inclusion criteria were anticipation of being present at the time of simulation, speaking English and no prior survey participation. Categorical variables were described as frequencies and percentage.
Results: : 50/79 surveys from 18 courses were returned (response rate 68%, 2.8 surveys/course). Parent and patient demographics, and actions witnessed are described on table 1. Parents’ responses are shown on table 2. Parents unanimously agreed that they appreciated the training and preparation that staff underwent during emergency simulation. No parent disagreed with the statements that they felt reassured when such training occurred; that training could provide safer care for their child; and that such training should occur in all PICUs and wards. This was despite the fact that 20% of parents agreed that in-situ simulation is upsetting as it reminded them of what could happen to their child. Analysis of anxiety revealed that only 14% agreed that in-situ simulation caused additional anxiety; of the 14%, 71% also agreed that the associated noise and urgency contributed. All parents who were in the same room as the simulation disagreed that this caused them increased anxiety; 19% of parents who were not in the same room thought that this would cause them increased anxiety. 80% of parents agreed that they were adequately prepared for the simulation. Written comments were unanimously positive to the training such as “…have seen the real thing on PICU, training definitely pays off”.
Discussion/Conclusions: : Parents overwhelmingly supported in-situ simulation events as they agreed that it gives them reassurance and improves their confidence in staff practice, enabling staff to provide safer care to their child. In-situ simulation faculty should ensure that parents are prepared for what happens during the in-situ simulation to help lessen their anxiety.