Our colleagues at the University of Alabama have embraced simulation safety! During a recent visit to the Office of Interprofessional Simulation for Innovative Clinical Practice (OIPS), several examples of simulation safety practices were evident.
The fake medications are clearly labeled. More importantly, the task of labeling is assigned to a specific person, who checks regularly to ensure that any new items are labeled “Not for Human Use, Education Only”
Policy for Actual Emergency
The center has a policy for managing real emergencies, which is clearly posted throughout the center. The simulation center looks like an authentic clinical environment, and if a learner or staff were to become ill or injured, there could be confusion or delay. Clear instructions are posted with emergency phone numbers to summon help for real events.
In Situ Simulation
In situ simulations are conducted regularly by the OIPS team. These drills are conducted to test the hospital system and to identify strengths, weaknesses, opportunities, and threats in clinical systems, the environment, or among teams.
The OIPS team presented a workshop on in situ simulation at the International Meeting on Simulation in Healthcare (IMSH) in January 2019. The panel provided a comprehensive guide for implementing an in situ simulation program. April Belle, MSN, RN, Director of In Situ Simulations, provided many specific recommendations for reducing the risk to patients and staff during these drills.
The OIPS website section on in situ simulation features a photo of the team transporting a mannikin to a drill. The IV bag is clearly labeled with a FHSS safety label. Many thanks to the team for their commitment to simulation safety!
We are happy to share another translation!
The simulation safety editorial is now available in Portuguese, thanks to the work of our colleagues from Brazil: Dr. Henrique Pierotti Arantes and Carolina Alexio. Dr. Arantes is the coordinator of the IMEPAC Araguari – MG Medical Course in Araguari, Brazil. More information about the IMEPAC Simulation Center can be found here.
Thank you Henrique for your time and talent!
The translated version is here: Juramento
The message of simulation safety is spreading to our Spanish-speaking colleagues!
We are so grateful to Priscilla Carmiol-Rodríguez for translating our editorial to Spanish. Priscilla teaches at at the University of Costa Rica’s Healthcare Simulation Center, and has worked in healthcare simulation for over 7 years. The Simulation Center is located at the Nursing School, and is an SSH accredited center.
Our colleagues generously agreed to review the translation, and provided valuable feedback. Demian Szyld, MD is the Senior Director of the Institute for Medical Simulation at the Center for Medical Simulation in Boston. José Mª Maestre, MD is the Director of Educational Innovation at Virtual Hospital Valdecilla in Santander Spain, and is on the faculty of Institute for Medical Simulation, Center for Medical Simulation in Boston.
We thank Pricilla, Demian and José for your time and talent!
The translated version is here: Seguridad Primero
Simulation Safety was the topic of a recent Journal Club hosted by Darin Abbey, RN at the Centre for Interprofessional Clinical Simulation (CISCL) The journal club is a monthly event to engage in critical discussion of emerging practices related to clinical simulation education.
The session included discussion of each element of the Simulation Safety Pledge. Prior to the meeting, Darin asked the group to read the Pledge and consider the following:
- Describe a safety hazard that you can imagine, or that your simulation program has experienced, which adherence to this pledge would mitigate.
- What specific measures do you imagine your simulation program would have to undertake to fulfill the intention of this pledge item?
This format resulted in thoughtful discussion and examination of each item of the pledge. The group shared their current practices and reflected on possible changes to their practices and how to engage their teams. The journal club is recorded and posted on the CICSL webpage. This journal club has covered lots of great topics; the link is here . They also discussed a safety checklist for in situ drills. This tool is on the FHSS website.
After listening to the journal club, we wanted to clarify some aspects of the the simulation safety pledge. There were some good discussions about whether certain items were applicable to every setting, as well as challenges to implementation and 100% compliance. It was evident that the group examined each item seriously, and they were open to expressing concerns about sections of the pledge. This is a positive thing; it would not be helpful to nod politely and accept the pledge without question! We offer the pledge as a list of sound practices, not as a command to be followed. This as a living document, and we are eager to hear input about revisions and additions.
We are so grateful to Darin for leading this discussion and for sharing with the FHSS. We look forward to further collaborations!
It is important to label simulation supplies to warn clinicians that they are not safe for human use. The first examples that come to mind are fake or expired medications, non-functional equipment, and unsterile instruments.
Also consider how your AED trainers are labeled and stored. In an emergency, it would be quite easy to mistake the trainer for a real AED, which could cause a life-threatening delay in care.
Do you use EpiPen trainers? These look so similar to the real thing! A scary incident occurred at a middle school recently when a student injected real epinephrine (adrenaline) instead of the trainer.
We have had a steady stream of label orders on our website. The labels are also available for free download, so we are hopeful that the use of labels is increasing. We are pleased to see some progress in adoption of a standardized label.
During IMSH 2018, we visited several vendors in the exhibit hall. Many companies have warning labels on their products, but we are concerned that this remains inconsistent. We were quite pleased to learn that Wall-Cur has adopted the FHSS graphic on all their products!
We are interested to hear from you! Please share photos of your labels in use by sending them to us here, or post your photos on Twitter and Instagram with the hashtag #tokeepsimsafe .
2018 was a good year for the Foundation for Healthcare Simulation Safety. We started the year at IMSH 2018 with a successful workshop and many good conversations about simulation safety with our colleagues.
We had a steady stream of label orders throughout the year, which is a positive sign. Labels are but one part of the simulation safety strategy, and there is much work to be done. We are heartened to hear news about our colleagues who are implementing new safeguards and sharing them through publication, and on social media.
As the year ended, we celebrated the publication of our editorial: Simulation Safety First; An Imperative, jointly published in Simulation in Healthcare, Advances in Simulation, and Journal of Surgical Simulation. The response was quite positive and we hope to build on that in the upcoming year.
This year, we will use the blog to share news and updates.
Preview of Topics:
- Safety Labels
- Editorial Publication and response
- Journal Club: Safety Pledge
- Simulation Advisory Board
- Simulation Safety Survey
What would you like to add to this list?
Please share your ideas with us here.