7 The impact of in-situ simulation training on individual and team performance during real cardiopulmonary resuscitations on a paediatric intensive care unit (picu)

Outcome after cardiopulmonary resuscitation (CPR) is influenced by the resuscitation team response.1–3 Our in-situ simulation training programme aims to improve patient outcome by rehearsing the team response to simulated crises including cardiac arrests.4 There is a relative paucity of translational research on the impact of simulated team training on real resuscitations.5AimsWe aimed to assess the impact of simulation training on individual performance, team-working and Crisis Resource Management (CRM) during real cardiopulmonary resuscitations (CPR).MethodsBi-monthly simulation sessions include advocacy-enquiry debriefing and CRM training. Cardiac arrests on PICU requiring at least 2 minutes of CPR were audited (1.5.2014 to 31.5.2015). Following each resuscitation, team members completed anonymous questionnaires scoring team resuscitation performance using the validated TeamMonitor tool4 and the impact of prior simulation training on self-rated performance.Results234 resuscitation questionnaires from 36 cardiac arrests were analysed.Prior simulation training was highly significant particularly for improving individual overall CPR performance and assisting early calls for help for the resuscitation (p = 0.001).Prior simulation training improved staff self-rating of performance and confidence during the resuscitation with little variability and strong mean agreement across groups.Level of agreement (0–100%) by professional group (Median; IQR)Doctors (n = 90)Nurses (n = 128)Surgeons (n = 10)P valueSimulation training has improved inter professional communication on PICU80 (70; 90)80 (70, 90)70 (30; 80)0.0123*Attending simulation training has helped me to perform better overall in today’s resuscitation80 (70; 100)80 (70; 90)70 (60; 85)0.131Simulation training has helped with the following during this event:Calling for help early80 (70; 100)80 (70; 100)80 (60; 100)0.778Clarity of role/appropriate role allocation90 (75; 100)80 (70; 95)80 (70; 100)0.619Expressing my opinion/empowerment to speak out80 (70; 95)80 (70; 90)80 (65; 90)0.823Communication with the team80 (78; 92)80 (75; 90)80 (70; 90)0.535Reducing my anxiety80 (60; 90)80 (60; 90)75 (60; 90)0.52Prioritisation of tasks80 (70; 90)80 (70; 90)80 (70; 90)0.798Leadership80 (70; 90)80 (65; 90)80 (65; 90)0.504Appropriate use of resources80 (70; 90)80 (70; 94)80 (70; 95)0.316Confidence in my role70 (80; 90)80 (70; 96)85 (75; 100)0.582Significance tested using Kruskal-Wallis for non-normally distributed respons