Using high fidelity simulation as an innovative approach to family education for children requiring chronic ventilation

Purpose:
Preparing family caregivers for children requiring long term mechanical ventilation (LTMV) for emergencies poses challenges. Our Ventilator Care Program (VCP) developed an innovative and unique experience for caregivers utilizing high fidelity simulation.

Relevance/Significance:
Educating a caregiver on LTMV and tracheostomy care requires creative and innovative teaching strategies. Caregivers often report that hands on learning align with optimal learning styles. Our high fidelity simulation program takes an innovative and comprehensive educational approach to focusing on emergency preparation in the home setting. We hypothesized that implementation of a high fidelity simulation would increase caregivers comfort in emergency situations and decrease readmissions.

Strategy and Implementation:
Caregivers were offered the opportunity to participate in the training for this quality improvement project. Training involved one to three caregivers for each patient being discharge for the first time home on LTMV. All simulations took place in the hospital's simulation lab. Multiple plan-do-stud-act (PDSA) cycles were utilized to prepare the simulation team. Standard documents were created for simulation logistics including set up, take down, and debriefing questions. The simulation room was set up to mimic a home environment including utilizing home equipment. Scenarios were developed by the VCP to simulate home emergency situations. Consent was obtained for the videoing of the simulation. Caregivers completed a pre and post likert scale survey assessing their comfort level with caring for their child at home. Each simulation included debriefing sessions that allowed for performance reflection and assisted in identifying additional learning opportunities.

Evaluation:
Over a one year period, between April 2014-April 2015, 21 simulations were completed for 41 caregivers. Overall, caregivers reported that simulation was a good use of their time; assisted in preparing them to care for their child during a home emergency; debriefing helped them to learn how to identify additional learning needs; and they would like more scenarios and simulation time.

Implications for Practice:
Educating caregivers to care for children requiring LTMV is an integral part of health care delivery. High fidelity simulation for caregivers has shown to be an effective teaching strategy coupled with traditional interventions for children requiring LTMV.