EUSEM_Nationwide Program for training nurses in MCI Triage the impact of three different type of simulation
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1) The study compared the physiological stress responses and triage performance of nurses trained using three different simulation methods: live simulation, virtual reality, and table-top exercises. 2) While triage accuracy was the same across groups, nurses completed triage faster with live simulation compared to virtual reality and table-top exercises. 3) Live simulation and virtual reality increased systolic blood pressure more than table-top exercises, indicating higher physiological stress, likely due to their increased realism. However, this stress did not impact triage performance. 4) More data is needed as this was an initial report; a nationwide study will provide more insights into optimizing disaster triage training methods for nurses.
EUSEM_Nationwide Program for training nurses in MCI Triage the impact of three different type of simulation
- 1. Nationwide Program for training nurses in MCI Triage: the impact of three different type of simulation Ragazzoni L, Ingrassia PL, Sabatini E, Sabbatini S, Di Matteo L, Troiano H, Polcini F, Picone C, Petrini F, Della Corte F.
- 2. BACKGROUND • Several studies assessed the effects of training and teaching in Disaster Medicine using simulation systems on medical Stress Stress skills. Responses Reactivity • Anyhow stress responses in a simulated scenario and the relationship between stress reactivity and medical Medical Performance performance have been studied rarely. Simulated Scenario
- 3. Table-top exercises and Virtual Reality Table-top exercises and Virtual Reality simulation are establishing to be equally simulation are establishing to be equally effective compared to the Live Simulation but itit effective compared to the Live Simulation but is common to think that the high degree of is common to think that the high degree of realism achieved by drills produces aa more realism achieved by drills produces more BACKGROUND stressful situation for the participants compare stressful situation for the participants compare to the other. to the other. R Effective Stressful Situation ? Live Simulation ea l i Effective Stressful Situation s Virtual Reality m Effective Stressful Situation Table-top
- 4. THE aim OF THIS STUDY Stress Reactivity to compare the impact on Live Simulation physiologic stress response of three different simulation-based methods for training Virtual Reality nurses in mass casualty triage Triage Performance Table-top
- 5. METHODS • A prospective randomized controlled longitudinal study was designed • 51 nurses enrolled in an Italian first-level Master on principles of Disaster Preparedness and Management were randomized in three group • aiming at triaging 10 victims in a limited period of time (5 min) using the Simple Triage and Rapid Treatment (START) algorithm
- 6. METHODS The simulation environment and the victims’ clinical conditions 20-min lecture were identical in the three different simulations about MCI Triage (51 nurses) Group 1 Group 2 Group 3 (17 nurses) (17 nurses) (17 nurses) Table-top Virtual Reality Exercise Simulation Live Scenario
- 7. METHODS • Heart rate and blood pressure were recorded just before and after the simulations • The groups’ ability to manage the simulated triage scenario was then compared (times and triage accuracy) • One-way analysis of variance (ANOVA) for each student was used
- 8. RESULTS Times and triage accuracy • There was no difference in triage accuracy during the three exercises (average 7.56±1.23) • There was a marked difference in time to complete triage • Both G1 and G2 in the TT and VR used all the time they had available to complete triage (5 minutes) • G3 participating in the LS completed the triage operation in an average of 3.3±0.5 minutes
- 9. RESULTS Average Hearth Psysiological Stress (p =0.54) Parameters Before After Group 85 82 There was 1 bpm bpm no Table-top difference in heart 85 80 rate before Group 2 bpm bpm and after the Virtual Reality three simulations Group 3 80 76 bpm bpm Live Scenario
- 10. RESULTS Psysiological Stress Systolic Blood Pressure Parameters Before After Group 127 125 Interestingly systolic blood 1 mmHg mmHg pressure, which Table-top (p= 0.73) was not significantly different before Group 2 123 130 the exercises mmHg mmHg (p=0.23) showed (p< 0.05) a marked Virtual Reality increase in G2 (p<0.05) and in G3 Group 3 121 139 (p<0.01) mmHg mmHg Live Scenario (p< 0.01)
- 11. Conclusion the LS and VR had an increased physiologic stress This results could be Live Simulation levels, as measured by systolic blood explained by the high pressure degree of realism Virtual Reality achieved by VR and compared LS compared to TT. with TT Table-top
- 12. CONCLUSION Instead such a stress reactivity Stress Reactivity reported would seem to have no impact in improving or decreasing triage performance. Although nurses were exposed to a training session, the lack of familiarity with the new simulation tools could be the reason of the Triage higher time to complete TT and VR. Performance
- 13. CONCLUSION The data represents only an initial report of a future nationwide study that will include all the 180 nurses enrolled into the Master.