Just-in-time Interprofessional COVID-19 Intubation Training Improves Healthcare Team Preparedness (1090-003683) (To be presented in the session entitled, Research Abstract Oral: COVID-19)
Start time: Friday, January 22, 2021, 2:00 PM End time: Friday, January 22, 2021, 3:00 PM Session Type: Research Abstracts (Completed Studies)
Enhanced PPE and social distancing requirements during the COVID-19 pandemic have significantly changed protocols around team-based emergent intubations1. We hypothesized that healthcare teams would be relatively uncomfortable with new protocols and that interprofessional simulation training would improve confidence in future intubations. Simulation training has been shown to improve confidence in procedural skills, even in experienced providers2. Interprofessional simulation has been shown to improve teamwork and communication3. While social distancing guidelines and PPE conservation efforts added additional considerations to executing simulations safely, we believe that these effects will not negate the benefits of training.
We developed an interprofessional simulation-based training for ED physicians, ICU physicians, ED residents, ED nurses, and respiratory therapists. Working in teams of three as outlined in clinical guidelines (one physician/resident, one nurse, and one RT), participants watched a 10-minute prerecorded presentation reviewing protocols and best practices for intubating COVID patients. Groups then moved to a simulation room, where they prepared as a team to intubate a COVID patient. This included preparing equipment, donning PPE, and developing a plan. Mock PPE was used to preserve PPE stocks for patient care. After the patient was successfully intubated, the team cleaned their equipment and doffed their PPE. A physician facilitator was present throughout to answer questions that arose. A debrief was completed in a separate room. A post-session survey was completed either digitally or via paper. Social distancing was maintained throughout the training.
All 118 participants filled out the survey, for a completion rate of 100%. The role of participants who filled out the surveys was 29.8% RN, 28.1% RT, 26.3% ED resident, 15.8% ED Attending. The majority of participants had not yet participated in the intubation of a COVID-suspected patient (59.2%). Of those 42 who had, 21 (50%) had been involved in a single intubation, 12 (28.6%) had been involved in two, and 8 (20%) had been involved in three or more. Participants answered questions about the helpfulness of the training and preparedness of intubating a COVID patient. Answers were given on a 5 point Likert scale (1=least helpful/prepared; 5=most helpful/prepared).Participants reported that both portions of the training were helpful, with the simulation session scoring a slightly higher average (4.53 for the presentation, 4.74 for the simulation). Average preparedness for intubating a COVID patient improved from 3.4 before the session to 4.49 after (p<0.0001).
The COVID pandemic has forced many changes to the way that even common procedures such as intubation are performed in the clinical setting1. The need for social distancing and mandate to preserve PPE adds additional challenges to rollout of substantial simulation training. However, even with these restrictions, an interprofessional simulation-based training program significantly improved self-reported preparedness among emergency department teams.