EFFECTIVENESS OF SIMULATION-BASED TRAINING ON RESPIRATORY THERAPISTS’ CONFIDENCE IN MANAGING INTUBATED PATIENTS UNDERGOING HYPERBARIC OXYGEN THERAPY AND SKILLS’ ATTAINMENT AND RETENTION

SESSION TITLE: Call an RT! Novel Studies in Respiratory Care SESSION TYPE: Original Investigations PRESENTED ON: 10/09/2018 08:45 AM - 09:45 AM PURPOSE: To evaluate the effect of simulation-based training for respiratory therapists (RTs) on confidence in managing patients with respiratory failure ventilated via a Sechrist pneumatic ventilator and undergoing hyperbaric oxygen therapy (HBOT) and on skills’ attainment and retention. METHODS: This pre-post study included 11 RTs and underwent 4 sequential phases. Phase 1: A 5-point scale survey measuring RTs’ self-reported confidence in performing 6 broad skills to manage patients with a Sechrist pneumatic ventilator was administered. Phase 2: A one-on-one hands-on training in a simulated-environment using high-fidelity mannequins was conducted over a 1-month period and focused on 15 specific skills regarding assembly of ventilator circuit, ventilators’ operation and connectivity, manipulation of ventilators’ parameters and lung compliance, airway preparation prior to HBOT, dive protocols, and interprofessional communication. The training session was immediately followed by re-administration of the self-reported confidence survey and measuring skill attainment of the 15 skills using (a) self-assessment checklist and (b) 2 independent observers’ ratings using a checklist. Phase 3: Skill retention was measured in a simulation session 3 months after the training session by (a) 2 independent observers using the same checklist previously used and by (b) the RTs’ self-assessed retention of the 15 skills. All scales for skills’ attainment and retention were adapted from Benner's Stages of Clinical Competence (novice, competent, expert). RESULTS: Zero to one RT reported high confidence in all 6 skills in the pre-confidence survey compared to 3 in the post confidence survey. Five to six RTs reported novice on each of the 15 skills (skill attainment), while the 2 observers rated all RTs as competent on all skills. In the skill retention survey, 1-2 RTs assessed themselves as novice on 10 of the 15 skills. Examples of these skills are circuit assembly and attachment to HBOT chamber, setting parameters, coordinating with certified HBOT technician to provide air breaks, and adjusting ventilator in coordination with ascent. The skill retention ratings of the 2 observers on all skills were competent to expert. CONCLUSIONS: Simulation is an effective method to train RTs to safely manage intubated patients undergoing HBOT as evidenced by improvement in self-reported skill attainment and retention and observers’ ratings of clinical skills’ retention. The lower self-reported confidence and skills’ attainment and retention in comparison to observers’ ratings can be explained by setting high safety goals and warrant observations of clinical skills. CLINICAL IMPLICATIONS: Hands-on, individualized training using high-fidelity mannequins has the potential to expand RTs knowledge on HBOT and safely improve their skills of managing intubated patients. DISCLOSURES: No relevant relationships by Melissa Alvarez, source=Web Response No relevant relationships by Jenny Heins, source=Web Response No relevant relationships by Diego Maselli Caceres, source=Web Response No relevant relationships by Azizeh Sowan, source=Web Response No relevant relationships by Ana Vera, source=Web Response