'But how do we do that? What do we need?’ - Using multidisciplinary simulation to learn how to safely facilitate radiological imaging for ventilated neonates
TimeFriday, April 162:00pm - 2:20pm EDT
LocationEducation and Simulation
DescriptionPrior to 2019, magnetic resonance imaging (MRI) for ventilated neonates was not undertaken at our hospital. Instead, a dedicated neonatal transport team would transfer the patient to the tertiary centre for imaging and then repatriate the patient. Due to the intensity of resources required for this 40 minute procedure, it was proposed that the teams and facilities at our trust should facilitate this instead. Training on using the transport incubator is provided at induction and team members are designated on the day to assist. Previously, the procedure has taken over 4 hours to complete.
A multi-professional, inter-specialty in-situ simulation was delivered whereby a ventilated neonate was transported from the neonatal unit to MRI. The neonatal and radiology team were briefed and were asked to stay in their normal roles. Once the scenario was completed, the team were debriefed using a diamond debrief model and written feedback was requested to obtain qualitative and quantitative responses.
There were 6 candidates from the neonatal and radiology department. Reflective comments were overwhelmingly positive, with candidates explaining how the simulation helped to understand each other’s roles or ‘the strengths and failings in our common knowledge’. Candidates commented how this simulation had improved their confidence, with the average confidence score in managing this scenario increasing from 3.33 (where 1 is very low confidence to 5 as very high confidence) to 4.5. Two candidates suggested that equipment stocks needed to be re-evaluated e.g. MRI compatible ventilators and two others suggested formalising the process into a checklist or protocol and then running the scenario again.
This simulation demonstrated why simulation based education is key to identifying latent threats and knowledge gaps due to systemic flaws. Since conducting this simulation, several changes have been made to the process in line with hierarchical task analysis, failure modes and effects analysis and the candidates feedback. From a neonatal perspective, a checklist is being ratified as well as a laminated instruction card on how to set up the transport incubator. The MRI team collated key action points and have circulated them to those working with paediatric patients. Overall, the simulation has established a better communication channel for both teams to liaise with each other to improve the patient experience and safety. We aim to run this scenario again when all these interventions have been approved for use.