Earlier this year, hospitals and healthcare works (HCWs) across the United States braced for a flood of COVID-19 patients. Since the illness spreads rapidly, following infection control protocols is key to keeping HCWs and patients safe. As such, Los Angeles County HCWs are using simulation-based training to prepare for an influx of COVID-19 patients and improve their clinical skills.
Doctors and nurses from the Perioperative COVID Task Force at LAC+USC Medical Center participated in a simulation drill to test and improve their infection control, communication, workflow, and patient care and transport skills. Although the team is used to working in high-stress environments, the drill helps keep their skills honed and ensures that there are no weak links in their process.
Since COVID-19 is highly infectious, the participants in the drill use real personal protective equipment (PPE) and practice how to put on and take off the PPE correctly. This is vital for HCWs to know considering a recent study found that one-third of HCWs became contaminated with harmful bacteria after caring for sick patients because they removed PPE incorrectly.
By continually practicing proper PPE donning and doffing, participants develop behaviors that become instinctual. Thus, the simulation ensures using PPE correctly is second nature to the team members, even during high-stress events wherein proper PPE use might not be an immediate priority in their mind. As a result, team members remain safe from contamination, and they avoid spreading illness to other patients.
The team provides care to a simulated patient using Gaumard’s HAL 3201 simulator. Since HAL can speak, produce lung and cough sounds, and he can be placed on real machines like a ventilator, the team can practice procedures hands-on. Research by educational theorists David Kolb and Ronald Fry posit that adults learn by doing. Through active, hands-on experiences, adults can observe and reflect on their work and change their actions based on what they have learned.
A clinician inexperienced with diagnosing and treating a COVID-19 patient can potentially make mistakes. Therefore, simulation-based training provides the team with opportunities to practice and gain experience in delivering effective care. Team members also receive feedback on their performance. Even if a mistake is made during the simulation, participants can practice and improve their skills, so they don’t make the same mistake in the real world.
According to Dr. Charlotte Garcia, an LAC+USC Medical Center faculty member and one of the team leaders during the simulation: “[The training we do] is to improve the LA County health system. We are the best team that the county can have, but we want to be better, especially [during the pandemic]”.
Moreover, the simulation helps LAC+USC Medical Center identify any potential threats in their protocols. By testing these protocols during a simulated event, changes can be made to the medical center’s policies that ensure the safety of patients and staff.
Additionally, surgical residents from the Keck School of Medicine of USC started learning critical care nursing skills using simulation. The surgeons-in-training are learning necessary skills like placing an IV line and adjusting a ventilator so they can fill in for overburden critical care nurses. Surgeons do not typically carry out these procedures. However, simulation-based training allows them to practice and gain experience so they can provide safe and effective care to real patients.
“Learning nursing skills — like putting in intravenous lines — supplements the physicians’ normal training…This will allow them to augment the critical care teams as we deal with the increased demand from this pandemic,” explained Meghan R. Lewis, associate director of the LAC+USC Surgical Intensive Care Unit.
The benefit of this training is two-fold for USC: students learn a new range of skills that make them adaptable healthcare providers, and they reduce the risk of HCW burnout, which can compromise the safety of patients and staff. Thus, simulation-based training is helping the LAC+USC Medical Center ensure their capacity to provide care is not compromised during the pandemic.
To read more about the simulation-based training done at the LAC+USC Medical Center, click on the link.