A multidisciplinary simulation training programme in the hyperacute stroke unit

Published Date: 10th July 2018

Publication Authors: Attwood K, Hill AM, Rowson M, Seed A

Background and Aims

High-quality care of stroke patients delivered on Hyperacute Stroke Units (HASUs) has been one of the primary contributors to reductions in stroke mortality and institutionalisation. Effective multidisciplinary management of the unwell stroke patient is an essential skill unique to this environment. Simulation training is a well-recognised means of training for improving confidence and competence in high-pressure acute situations. A small evidence base exists on simulation training specifically for stroke medicine.

Method

We established a simulation programme focusing on unwell patients and acute deterioration on the high-dependency Hyperacute Stroke Unit. The monthly sessions were performed in the HASU itself, attended by nursing and therapy staff. The aim was to improve confidence in identifying and managing acutely unwell patients in clinical team members who may not have formal clinical assessment training. Dedicated simulation trainers facilitated sessions, using a Laerdal SimMan 3G system with Laerdal LLEAP software. A clinical area was used for realism and to identify latent errors arising from the clinical environment itself. Video recording allowed immediate debriefing with objective feedback for the group.

Results

Formal staff feedback showed increased confidence in basic assessment of unwell stroke patients and improved team-working.

Conclusion

A high-quality stroke-orientated simulation programme can be established with standard simulation equipment and techniques. All members of the stroke multidisciplinary team can benefit, showing subjective improvements in team-working and confidence. Further work is needed on objective measures but we would encourage other HASUs to develop their own simulation programmes.

 

Seed, A; Hill, A; Attwood, K; Rowson, M. (2018). A multidisciplinary simulation training programme in the hyperacute stroke unit. European Stroke Journal. 3 (Suppl 1), 295

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