59 - Inter-professional Simulation in the Operating Room
Purpose: The Joint Commission continues to report a high frequency of sentinel events. Breakdown in communication has been identified as one of the root causes of patient errors with the operating room (OR) noted as a high risk area. Inter-professional simulation training in the OR is one educational approach to improving communication among surgical teams. Literature Review: The Institute of Medicine, Joint Commission, World Health Organization, and Association of periOperative Registered Nurses support inter-professional collaboration. Principles of aviation have entered the healthcare arena to utilize simulation training to create a culture of safety. Team training improves communication and teamwork.Research Question: What is the impact of inter-professional simulation on operating room staff? Conceptual Framework: Experiential Learning Theory aligns with inter-professional simulation in the OR. Simulation allows learners the opportunity to practice decision making, delegation, prioritization, and teamwork in a safe environment.
Methods: A comprehensive search with search terms communication AND team training AND operating room AND simulation was conducted in PubMED yielding 79 articles and CINAHL, MEDLINE, and ERIC yielding 248 articles. Filters were full text, English, peer-reviewed journals between January 2008 to December 2018. Data Analysis: A data matrix was developed with critical appraisal of each article. A comparison of findings was completed to develop a synthesis of themes and conclusions.
Results: This integrative review examined 12 articles, 8 quantitative, 4 mixed methods. Four key themes emerged with improvements in: communication, role clarification, team cohesion, and changes in personal behaviors.Conclusions/
Discussion: Inter-professional simulation has a positive impact on OR teams. Formal debriefings are essential for effective communication. Reinforcement training is recommended to maintain speaking up behaviors. Team cohesion continues post-training. Simulation breaks down hierarchal barriers. Training increases confidence in handling crisis situations and inspires staff to provide safer care. This training positively impacted the staff’s perception of the safety culture of their institution and efforts aimed at improving patient care.Periooperative Nursing Implications: Simulation experiences allow nurses to recognize the integral role they play as part of the OR team. Gaining confidence in sharing critical information and voicing safety concerns is an essential part of patient advocacy. Inter-professional collaboration could lead to the development of future policies and protocols. Nurses should participate in future research to understand the transfer to clinical practice and the impact it has on patient outcomes.