“Never in This Alone.” Simulations of Real-life Medical Events Prepare Entire Units

Morgan LePoire speaks with “Bob” as part of the simulation directly in the 3 Lacks unit.

“Perform the role you normally do while at work” is the first instruction for 3 Lacks staff at Mercy Health Saint Mary’s as they begin a simulation exercise in which a manikin is “coding,” (having his heart stop).

Building on a successful simulation lab program of more than six years, comprehensive inpatient care teams are now performing simulated exercises right on their units at Mercy Health Saint Mary’s, thanks to a two-year grant from Trinity Health. In September 2017, the Trinity Assurance LTD Grant began to fund I-PEACE, a project in which the simulation lab—which includes a manikin and other monitoring and tracking equipment— is transported directly to departments within Mercy Health Saint Mary’s.

I-PEACE, which stands for improving communication through Inter-professional Education Across Care Environments, will allow multidisciplinary teams an opportunity to improve collaboration, thereby improving patient outcomes.

At the bedside, inpatient teams perform simulated health care scenarios focused on specific conditions that the grant is focused on, such as:

  • Sepsis,
  • Chronic Obstructed Pulmonary Disease (COPD), and
  • Congestive Heart Failure (CHF).
LePoire checks the vitals of her patient Bob during a simulation exercise. LePoire is a newly graduated bedside nurse who works on 3 Lacks.

These simulations are planned for Hauenstein 2, Hauenstein 3, 3 Lacks and 8 Main, as these teams care for the largest number of patients with these conditions.

The I-PEACE team consists of:
Nursing leaders Kristy Perez, BSN, RN, CEN, Professional Development Specialist and Simulation Coordinator, and Vicki Swendroski, RN, Professional Development Specialist, Sepsis and Simulation and medical education leadership, such as John VanSchagen, Michael Bishop and Mark Spoolstra.

“Truly, if we can impact the quality of care for our patients through improved communications within the staff of the unit, that would be the ultimate goal,” said Swendroski. “With improved communications and preparedness, we hope to enhance the patient experience and improve quality of care.”


Other nurses and members of the Rapid Response Team rush in during the simulation while LePoire performs CPR on Bob.

Witness a Simulation:

During the simulation, newly graduated registered nurse Morgan LePoire is the bedside nurse on 3 Lacks assigned to care for the manikin, named Bob, who is a 71-year-old male. LaPoire acts as if the manikin is a real patient, talking to him and checking his vitals.

The patient and scenario might not be real, but the steps and processes are very real, as the “patient” stops breathing, and the Rapid Response team is called, the physician-on-call is paged, and all nurses rush to the scene to assist with the simulated code. Even the social worker on 3 Lacks checks in. Nurses and rapid responders take turns performing hands-only CPR and using the defibrillator to attempt resuscitation.

After the few minutes of simulation is over, the team debriefs to see what they learned. The I-PEACE Team evaluates how the team performed and gives honest feedback about how the unit responds to the exercise, and the teams share learnings with each other.

“You’re never in this alone,” explains Swendroski to the 3 Lacks staff, especially to LePoire, during the debriefing. “You always have your other team members for assistance and guidance.”

Vicki Swendroski leads the debriefing with the 3 Lacks staff after the simulation exercise.

Advice that LePoire takes to heart: “Going into the simulation, I was definitely overwhelmed, but as the simulation went on, I realized that I had a lot of resources. It was encouraging to see the multidisciplinary team there for the patient’s benefit, and we are all working toward the same goal of healing and helping.”

While the simulation exercise only lasts a few minutes, the positive effects of the experience will last a lifetime for clinical staff: “As a new nurse, I knew the experience would be beneficial, and having a safe space to make mistakes and ask questions opened up a lot of opportunities for growth in confidence and knowledge,” recalled LePoire.

Would LePoire recommend the experience to others? “Yes, I highly recommend having simulations on the unit because it made sure that I had familiar faces and used the resources that I have on a daily basis at work! Despite the nerves and a little anxiety during the simulation, I learned a lot and gained new resources.”

The next step for this project will be to move from working on transitions in care related to a change in condition to working with the team on discharge planning for patients with sepsis, COPD and CHF.




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