Presentation
Applying Virtual Simulation to Complex Care Behavioral Health Patients in ICU Settings
DescriptionInjuries resulting from patient behavioral events (PBEs) accounted for 25.6% of all serious employee harm events for the Nursing & Clinical Care Services (NCCS) department at the Children’s Hospital of Philadelphia (CHOP). Post-event analyses and learning revealed that many employee PBE injuries could have been mitigated or avoided through standardized processes and accessible training, especially for medically complex patients. The outcome resulted in a just-in-time (JIT) virtual reality (VR) training module to help staff proactively prepare when caring for medically complex patients with BH needs.
A multidisciplinary team, including frontline clinicians, Nursing, BH experts, Employee Safety, Human Factors, and Simulation staff, reviewed multiple PBE events and conducted simulation and think-aloud techniques to assess team suggestions for best practices when engaging with medically complex patients with behavioral health (BH) concerns. The team started by collecting frontline experiences for how to engage in appropriate and safe body placement when assigned to a simulated medically complex patient with high BH needs. From frontline suggestions, the team utilized think aloud techniques to question and physically walk a mannequin through each suggestion until a pilot process was established. The pilot process was then 3D-modeled into the Education XR platform, resulting in the development of a virtual reality module. The module is currently undergoing multiple rounds of usability assessment from frontline clinicians to assess workflow impact and relevance.
The most frequently encountered scenarios by staff while assigned the safety observation role were identified and developed, including establishing the staff member's role for routine safety observation. Positioning of the staff members to reduce the risk of injury. Safely perform a staff transition to reduce the risk of injury. The multidisciplinary team recorded, modeled, and created a digital environment that replicated a typical behavioral health patient room within an ICU unit. Usability testing was completed among various roles, including Clinical Nurse, Senior Nursing Aid, Behavioral Health Clinician, and Nursing Leadership
Importance of Conclusion/Takeaway Points:
The think-aloud simulation enabled our multidisciplinary team to identify the major phases of care and what “needs to go right” to ensure the safety of both patients and staff. This exercise informed the development of an accurate virtual reality simulation that staff can use as proactive or just-in-time training. The next step is to pilot the simulation in the Pediatric Intensive Care Unit (PICU) to identify potential revisions and address additional considerations, including those related to diversity, equity, and inclusion for both staff and patient
A multidisciplinary team, including frontline clinicians, Nursing, BH experts, Employee Safety, Human Factors, and Simulation staff, reviewed multiple PBE events and conducted simulation and think-aloud techniques to assess team suggestions for best practices when engaging with medically complex patients with behavioral health (BH) concerns. The team started by collecting frontline experiences for how to engage in appropriate and safe body placement when assigned to a simulated medically complex patient with high BH needs. From frontline suggestions, the team utilized think aloud techniques to question and physically walk a mannequin through each suggestion until a pilot process was established. The pilot process was then 3D-modeled into the Education XR platform, resulting in the development of a virtual reality module. The module is currently undergoing multiple rounds of usability assessment from frontline clinicians to assess workflow impact and relevance.
The most frequently encountered scenarios by staff while assigned the safety observation role were identified and developed, including establishing the staff member's role for routine safety observation. Positioning of the staff members to reduce the risk of injury. Safely perform a staff transition to reduce the risk of injury. The multidisciplinary team recorded, modeled, and created a digital environment that replicated a typical behavioral health patient room within an ICU unit. Usability testing was completed among various roles, including Clinical Nurse, Senior Nursing Aid, Behavioral Health Clinician, and Nursing Leadership
Importance of Conclusion/Takeaway Points:
The think-aloud simulation enabled our multidisciplinary team to identify the major phases of care and what “needs to go right” to ensure the safety of both patients and staff. This exercise informed the development of an accurate virtual reality simulation that staff can use as proactive or just-in-time training. The next step is to pilot the simulation in the Pediatric Intensive Care Unit (PICU) to identify potential revisions and address additional considerations, including those related to diversity, equity, and inclusion for both staff and patient
Event Type
Oral Presentations
TimeTuesday, March 2410:30am - 10:52am EDT
LocationMorgan
Simulation and Education