Authors (including presenting author) :
Leung YWN (1) (2), Tsoi SC (2) (3), Chan MY (2) (4), Chau LTC (3)
Affiliation :
(1)Department of Intensive Care, Pamela Youde Nethersole Eastern Hospital
(2)Nethersole Clinical Simulation Training Centre (NCSTC), Pamela Youde Nethersole Eastern Hospital
(3)Nursing Services Department, Pamela Youde Nethersole Eastern Hospital
(4)Department of Accident and Emergency Care, Pamela Youde Nethersole Eastern Hospital
Introduction :
In COVID-19 pandemic, simulation training about the disease, medical emergencies management and infection control measures to nurses is crucial.
However, training needs would be variable depends on the area of deployment, experience and complexity of patients they were facing. A systemic 4-tier simulation training model was designed.
Objectives :
To increase the competency, and confidence level of nursing staff with different training needs and experience level in managing COVID-19 infected patients
Methodology :
Simulation training course consisted of (1) Information Update of COVID-19, (2) Immerse Scenarios on managing COVID-19 patients with debriefing highlighting the importance of Crew Resource Management (CRM), and (3) Skills Practice on airway management was designed and organized in NCSTC for nurses who are designated to be deployed to care patients with COVID-19.
Besides, tailor-made curriculum was implemented according to the need and level of experiences of participants:
Junior nurse (with < 3 years working experience)
Practical skills in specimen collection (DTS/NPA/NPS/Throat Swab), handling and related infection controls
Wards with mechanical ventilated COVID-19 cases
Essential knowledge in ventilator mechanics and simulation scenarios with ventilator emergencies (invasive and non-invasive) were practiced.
Tier 1 and 2 isolation ward or surveillance ward
Emergency management strategies for deteriorating patients in isolation room were discussed, e.g. minimizing aerolization and limited staff exposure.
Intensive Care Unit
Management highlights in critically-ill COVID-19 patients and ventilator emergencies
Evaluation measures
Pre- and Post-workshop questionnaire with Likert scale (1-6) was conducted to evaluate the effectiveness.
Result & Outcome :
Total 34 classes were organized from March to December 2020.
Junior nurses: 3 classes, 31 nurses.
Tier 1 and 2 isolation ward or surveillance ward: 25 Classes, 241 nurses.
Wards with mechanical ventilated COVID-19 cases: 4 classes, 38 nurses
Intensive Care Unit: 2 classes, 16 nurses.
There was statistical significant increase (p< 0.001, paired t-test) in pre and post evaluation results in many aspects, including the following questions:
1.I am competent to manage COVID-19 patients
2.I understand the possible contamination risks among myself, healthcare workers, and the environment.
3.I have equipped relevant knowledge and skills to minimize the contamination risks.
4.I know the principles of airway management for COVID-19 patients.
Specific questions also showed significant increase (p< 0.001, paired t-test):
Junior nurses:
1.I have equipped adequate practical skills and related infection control measures of specimen collection (DTS/ NPA/ NPS/ throat swab) for patients with COVID-19.
Wards with mechanical ventilated COVID-19 cases
1.I am confident in managing patients with non-invasive ventilator.
Intensive Care Unit:
1.I psychologically feel safe to manage patients with COVID-19 in isolation setting of intensive care unit.
The 4-tiers simulation training model for COVID-19 achieved a positive impact in increasing nurse’s competency, confidence and understanding of infection control in caring patients with COVID-19.
