Aim The aim of our project is to provide safe resuscitations in a small district general hospital (DGH) as measured by the clinical incidents, patient outcomes and staff feedback.
Method Regular multi-disciplinary scenario based resuscitation training sessions were provided, at the point of care. These training cycles focused on the needs of the local team of a small DGH. Regular feedback was obtained from participants. Clinical incidents were analysed for a year before and after the point in time when training was initiated
Results The first Plan-Do-Study-Act (PDSA) cycle of training was delivered along the standard resuscitation training provided in UK Life Support courses. It was immediately obvious that the training required to be more focused towards local needs, which were more extensive compared to that provided in life supportive courses. 3 subsequent PDSA cycles focused on individual and team needs in a multi-disciplinary team such as drills for infusions, setting and using ventilator, airway skills and providing leadership while working in a resident shift. Analysis of the reported clinical incidents, anonymised staff feedback, reflection from resuscitations, personal stories and opinions of the team members - all formed the basis of a series of the next 4 PDSA cycles of resuscitation training. Many of these incorporated simulations of locally performed resuscitation scenarios such as trauma, burns and status epilepticus. The last 4 PDSA cycles were focused on the current needs of a new team, to develop resilience and challenge through human factors and team strategies and tools to enhance performance and patient Safety (TEAM STEPPS). We have at present achieved a steady state.
The staff feedback of these training sessions has been very positive. The clinical incidents of medium and high risk have been reduced by half, while overall incident reporting rate has increased by 1.7 times, promoting an open culture and risk anticipation.
Conclusion Regular multi-disciplinary training focused on the local team and task needs seems to provide safer resuscitations in a small DGH, with a low frequency of resuscitations. This approach might be of use at any clinical site having a potential risk of infrequent paediatric resuscitations.
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