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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
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Transportable enhanced simulation technologies for pre-implementation limited operations testing: neonatal intensive

Jesse Bender1, Robin Shields, Karen Kennally

  • 1Department of Pediatrics, Women & Infants' Hospital, Providence, RI 02905, USA. gbender@wihri.org

Simulation in Healthcare : Journal of the Society for Simulation in Healthcare
|May 7, 2011
PubMed
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Simulation testing before NICU transition identified and resolved numerous safety hazards. Staff felt better prepared for new workflows and equipment, improving patient care during the move to single-family rooms.

Area of Science:

  • Healthcare simulation
  • Patient safety
  • Neonatal intensive care unit operations

Background:

  • Transitioning a Neonatal Intensive Care Unit (NICU) to a new facility presents challenges, especially when shifting from cohort-based care to single-family rooms.
  • Altered healthcare delivery systems require in situ testing before implementation.
  • TESTPILOT (Transportable Enhanced Simulation Technologies for Pre-Implementation Limited Operations Testing) was utilized to test changes.

Purpose of the Study:

  • To promote the translation of existing processes during NICU transition.
  • To identify necessary staff orientation materials.
  • To hypothesize that process gaps would be discovered and resolved, and staff would feel better prepared.

Main Methods:

  • A functional NICU was modeled before opening for in situ simulations.

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  • Multidisciplinary participants performed usual duties in simulated scenarios.
  • Latent safety hazards were identified, corrected, and retested through iterative debriefings.

    • Main Results:

    • 164 latent safety hazards were identified across communication, facilities, supplies, staffing, and training.
    • 93% of identified hazards were resolved before the transition.
    • Staff reported improved communication, workflow, and awareness of resources, with most feeling their practice changed.

    Conclusions:

    • In situ simulation effectively identifies process gaps before major institutional changes like NICU transitions.
    • TESTPILOT facilitated iterative workflow enhancements and staff orientation, improving patient care.
    • The coordination for large-scale simulations is valuable for systems refinement and patient safety.