International Journal of Healthcare Simulation

Background:

Lack of training materials for Post Anaesthetic Care Unit (PACU) staff leads to the creation of a ‘choose your own adventure’ style VR training package, working collaboratively with the TEL team and incorporating quality improvement methodology prior to rollout. The development of this training package was initiated following the introduction of a theatre-specific induction programme, during which it was discovered that the learning opportunities for PACU staff were limited, particularly during the COVID-19 response.

Aims:

Therefore, the aim of creating this learning package was to make available more interactive learning opportunities for PACU staff, giving them the chance to develop their knowledge and skills in a safe environment, without the pressure of a live patient.

Method/design:

Planning was completed in collaboration with a Theatre Practice Educator and Simulation and Human Factors Fellow. This was initiated with the use of a modified decision tree as shown in figure one. Following completion of this, the Technology-Enhanced Learning (TEL) Lead and clinical expert advice were sought to assist in the creation of high-quality content. Communication was then sent out seeking actors and location/dates for filming were planned. Appropriate consent was gained from all participants involved. Filming had to be planned around theatre utilization; therefore, it was necessary for this to take place on audit sessions dedicated to training of theatre staff. After the completion of filming, further collaboration with the TEL Lead was required to create the learning package. On completion of the package, it was shared with experienced members of PACU staff to test the quality and validity of the learning experience. At this point, a quality improvement approach was adopted with the use of PDSA (Plan-Do-Study-Act) cycles. Adopting this approach allowed adjustments to be made to the package before it was utilized on a larger scale.

Implementation outline:

The learning package was implemented rapidly after completion. It was immediately included in the Theatre Induction Programme for every PACU member of staff and was also then available to be utilized on audit training sessions for existing PACU staff. This learning package was a creative approach, exploiting technology not yet harnessed within our speciality. Patient post-Anterior Repair brought into PACU with an LMA (Laryngeal Mask Airway) in situ, spontaneous respirations are present.

Patient regains consciousness:

LMA expelled:

Laryngospasm – recognize – 02, Waters Circuit/PEEP

Vomit – positioning – suction – anti-emetics

PV PAIN – check wound – analgesia (ineffective)

Get help

Laryngospasm has broken with PEEP

Auscultation and order chest x-ray

Multimodal analgesia – add patient PV pack band