Simulation Training to Increase Holding of Fragile Infants in Cardiac Intensive Care Units.


Journal

American journal of critical care : an official publication, American Association of Critical-Care Nurses
ISSN: 1937-710X
Titre abrégé: Am J Crit Care
Pays: United States
ID NLM: 9211547

Informations de publication

Date de publication:
01 Sep 2024
Historique:
medline: 1 9 2024
pubmed: 1 9 2024
entrez: 31 8 2024
Statut: ppublish

Résumé

Promoting bonding and neurodevelopmental care is an important element in the cardiovascular intensive care unit (CICU); however, holding of infants by family members is inconsistently practiced. This quality improvement study aimed to safely increase the holding of medically complex infants in the CICU by developing a holding guideline and offering simulation-based staff education. Using consensus methodology and high-fidelity simulation, an expert work group created a holding guideline and training to increase staff confidence and competence in holding critically ill infants in the CICU. The effectiveness of the intervention was tested via a postintervention survey used to assess participants' confidence in and comfort with holding critically ill infants and elicit suggestions for further support. Participants who engaged with the mannequin were surveyed to assess the validity of the simulation trainer. After the intervention, participants (N = 130) reported increased confidence with infant holding (76%) and greater confidence in preparing families to hold their infants. Participants (95%) strongly agreed that the simulation enabled realistic, safe practice in holding a medically complex infant with catheters and tubes. More years of experience and engagement with the simulation trainer were associated with increased posttraining confidence. Participants cited increased resources, practice, and adherence monitoring as key supports for infant holding. Expert group consensus with high-fidelity simulation training is a feasible, safe, and reliable method for teaching higher risk skills and guiding protocol development.

Sections du résumé

BACKGROUND BACKGROUND
Promoting bonding and neurodevelopmental care is an important element in the cardiovascular intensive care unit (CICU); however, holding of infants by family members is inconsistently practiced.
OBJECTIVES OBJECTIVE
This quality improvement study aimed to safely increase the holding of medically complex infants in the CICU by developing a holding guideline and offering simulation-based staff education.
METHODS METHODS
Using consensus methodology and high-fidelity simulation, an expert work group created a holding guideline and training to increase staff confidence and competence in holding critically ill infants in the CICU. The effectiveness of the intervention was tested via a postintervention survey used to assess participants' confidence in and comfort with holding critically ill infants and elicit suggestions for further support. Participants who engaged with the mannequin were surveyed to assess the validity of the simulation trainer.
RESULTS RESULTS
After the intervention, participants (N = 130) reported increased confidence with infant holding (76%) and greater confidence in preparing families to hold their infants. Participants (95%) strongly agreed that the simulation enabled realistic, safe practice in holding a medically complex infant with catheters and tubes. More years of experience and engagement with the simulation trainer were associated with increased posttraining confidence. Participants cited increased resources, practice, and adherence monitoring as key supports for infant holding.
CONCLUSIONS CONCLUSIONS
Expert group consensus with high-fidelity simulation training is a feasible, safe, and reliable method for teaching higher risk skills and guiding protocol development.

Identifiants

pubmed: 39217108
pii: 32526
doi: 10.4037/ajcc2024658
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

338-346

Informations de copyright

©2024 American Association of Critical-Care Nurses.

Auteurs

Christine Rachwal (C)

Christine Rachwal is a nurse practice specialist, Department of Nursing, Boston Children's Hospital, Boston, Massachusetts.

Melissa Smith-Parrish (M)

Melissa Smith-Parrish was a cardiac intensivist in the Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts.

Valerie Rofeberg (V)

Valerie Rofeberg is a statistician, Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts.

Kelsey Graber (K)

Kelsey Graber was a clinical research specialist, Immersive Design Systems, Boston Children's Hospital, Boston, Massachusetts.

Duncan Smith-Freedman (D)

Duncan Smith-Freedman was a simulation engineer specialist II, Immersive Design Systems, Boston Children's Hospital, Boston, Massachusetts.

Marlena Smith Millman (MS)

Marlena Smith Millman was the manager of systems improvement, Immersive Design Systems, Boston Children's Hospital, Boston, Massachusetts.

Meagan Garafalo (M)

Meagan Garafalo was a simulation production engineer II, Immersive Design Systems, Boston Children's Hospital, Boston, Massachusetts.

Sonia Almeida-Santos (S)

Sonia Almeida-Santos is a staff nurse III, Department of Nursing, Boston Children's Hospital, Boston, Massachusetts.

Michelle Panaccione (M)

Michelle Panaccione is a staff nurse II, Department of Nursing, Boston Children's Hospital, Boston, Massachusetts.

Angela Sorensen (A)

Angela Sorensen is a staff nurse II, Department of Nursing, Boston Children's Hospital, Boston, Massachusetts.

Suzanne Stuzynski (S)

Suzanne Stuzynski is a staff nurse II, Department of Nursing, Boston Children's Hospital, Boston, Massachusetts.

Karen Horn (K)

Karen Horn is a staff nurse III, Department of Nursing, Boston Children's Hospital, Boston, Massachusetts.

Gina Ubertini (G)

Gina Ubertini is a staff nurse I, Department of Nursing, Boston Children's Hospital, Boston, Massachusetts.

Shana Peruti (S)

Shana Peruti is a staff nurse I, Department of Nursing, Boston Children's Hospital, Boston, Massachusetts.

Samantha C Butler (SC)

Samantha C. Butler is a pediatric clinical psychologist and associate professor, Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, and Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.

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Classifications MeSH