Simulation Training Exercise to Improve Outcomes of Emergence Delirium in Patients With Posttraumatic Stress Disorder

Information in the perianesthesia environment may not be communicated across healthcare disciplines, potentially causing division on best practice. An example is emergence delirium, which requires a timely cohesive response. Patients with posttraumatic stress disorder (PTSD) may be more susceptible to emergence delirium. Simulation is an effective method to rehearse and act on clinical situations without harming the patient. The authors developed an interprofessional, interinstitutional simulation exercise to unify the perianesthesia team's interventions based on recommended practices for patients who have PTSD and are exhibiting emergence delirium. The simulation was tested at an Army community hospital and a Veterans Affairs hospital. Staff rotated through 3 simulation stations located in the preoperative holding area and an operating room suite. A pretest and prerequisite reading with application and analysis of the content was performed before the simulation. After completing the simulation and before returning to patient care, participants completed the posttest. The pretest vs posttest average score was 49.2% vs 81.6%. Based on written and verbal evaluations, the exercise accomplished the goals of evaluating templates of a simulation exercise for perianesthesia personnel to work collaboratively in an interdisciplinary environment in an emergency situation that met the learning needs of anesthesia and nursing personnel.