Improving Safety and Quality During Interhospital Transfer of Patients With Nontraumatic Intracranial Hemorrhage: A Simulation-Based Pilot Program.

Background: The presentation of critically ill patients to emergency departments often necessitates interhospital transfer (IHT) to a tertiary care center for specialized neurocritical care. Patients with nontraumatic intracranial hemorrhage represent a critically ill population subject to high rates of IHT and who is thus an important target for research and quality improvement of IHT. We describe the use of an innovative simulation methodology engaging transfer staff, clinicians, and stakeholders to refine and facilitate the adoption of a standardized IHT protocol for transferring patients with neurovascular emergencies.

PROcess for the Design of User-Centered Environments (PRODUCE): Guiding Change in the Health Care Environment.

Changes in the physical environments of health care settings have become increasingly common to meet the evolving needs of the health care marketplace, new technologies, and infrastructure demands. Physical environment change takes many forms including new build construction, renovation of existing space, and relocation of units with little to no construction customization. The interrelated nature of the complex socio-technical health care system suggests that even small environmental modifications can result in system-level changes.

The effectiveness of a novel colorant additive in the daily cleaning of patient rooms.

The quality of daily cleaning was assessed comparing a standard bleach product with the bleach product containing a novel colorant additive in an inpatient setting. Effectiveness was assessed using fluorescent markings and microbiological analysis of environmental and experimental specimens. Our findings showed no significant difference in cleaning between these groups.

Workload of Team Leaders and Team Members During a Simulated Sepsis Scenario.

Objectives: Crisis resource management principles dictate appropriate distribution of mental and/or physical workload so as not to overwhelm any one team member. Workload during pediatric emergencies is not well studied. The National Aeronautics and Space Administration-Task Load Index is a multidimensional tool designed to assess workload validated in multiple settings.

Utilization of exploration-based learning and video-assisted learning to teach GlideScope videolaryngoscopy.

Background: GlideScope (GS) is used in pediatric endotracheal intubation (ETI) but requires a different technique compared to direct laryngoscopy (DL).

Purposes: This article was written to evaluate the efficacy of exploration-based learning on procedural performance using GS for ETI of simulated pediatric airways and establish baseline success rates and procedural duration using DL in airway trainers among pediatric providers at various levels.

Methods: Fifty-five pediatric residents, fellows, and faculty from Pediatric Critical Care, NICU, and Pediatric Emergency Medicine were enrolled.

Simulation-based training in brain death determination.

Background: Despite straightforward guidelines on brain death determination by the American Academy of Neurology (AAN), substantial practice variability exists internationally, between states, and among institutions. We created a simulation-based training course on proper determination based on the AAN practice parameters to address and assess knowledge and practice gaps at our institution.

Methods: Our intervention consisted of a didactic course and a simulation exercise, and was bookended by before and after multiple-choice tests.

The 3D model of debriefing: defusing, discovering, and deepening.

The experiential learning process involves participation in key experiences and analysis of those experiences. In health care, these experiences can occur through high-fidelity simulation or in the actual clinical setting. The most important component of this process is the postexperience analysis or debriefing.

Theoretical foundations of learning through simulation.

Health care simulation is a powerful educational tool to help facilitate learning for clinicians and change their practice to improve patient outcomes and safety. To promote effective life-long learning through simulation, the educator needs to consider individuals, their experiences, and their environments. Effective education of adults through simulation requires a sound understanding of both adult learning theory and experiential learning.

High-fidelity medical simulation as a technique to improve pediatric residents' emergency airway management and teamwork: a pilot study.

Objective: High-fidelity medical simulation is a technique used for training residents. Simulation is used to teach procedural skills and teamwork. There are limited data on the efficacy of this educational technique.

High-fidelity medical simulation as an assessment tool for pediatric residents' airway management skills.

Objectives: To evaluate high-fidelity medical simulation as an assessment tool for pediatric residents' ability to manage an acute airway.

Methods: We performed a prospective, observational study in which 16 pediatric residents were consented and then brought to the medical simulation center. They were placed in 2 different computer-driven scenarios and asked to manage the cases.