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Clinical simulation helps improve healthcare for veterans

Monday October 14, 2013
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The Michael E. DeBakey VA Medical Center in Houston is home to the new Simulation, Training, Assessment and Resource lab, which offers state-of-the-art equipment and many more opportunities for simulation-based training and education research. The STAR lab is equipped with a SimMan 3G, a human patient simulator that exhibits human physiologic functions such as blood pressure readings, reactive pupils, working tear ducts and heart and lung sounds. The medical center will use this technology to provide realistic training opportunities such as starting an IV, obtaining a blood sample, inserting a bladder catheter, giving medications, treating wounds and performing procedures, according to a news release.

According to lead simulation instructor Racquell Garrett, RN, MSN, the Institute of Medicine’s Report “To Err is Human: Building a Safer Health Care System” recommends all educational and healthcare institutions incorporate simulation in clinical settings to prevent errors and improve patient outcomes. 

“The MEDVAMC is committed to providing quality care to our veterans, and we are adhering to this recommendation to institute simulation to train clinical staff,” Garrett said. “The VA simulation lab is available to all clinical staff including physicians, nurses, nurse practitioners, physician assistants, respiratory therapy, nursing assistants, health technicians and nutritionists. This interdisciplinary approach to training also facilitates effective interprofessional communication between disciplines, which improves patient care.”

At the medical center, Garrett said they use human patient simulators to provide training in cardiac arrest to train physicians and nurses on their role and performance during a code situation, and to identify signs a patient is decompensating. 

“While these disciplines come to the lab with knowledge and skill to participate in a code, the use of simulation provides our clinical staff with the opportunity to refine skills,” she said. “We have the capability to record staff during scenarios and to replay so that we can point out the positive outcomes and discuss areas for improvement. Ideally, the use of the lab will not just train staff on clinical skills but to master skills and interprofessional adherence to processes and protocols to improve patient outcomes.”

The STAR lab also will provide MammaCare Clinical Breast Exam Simulators. Because performing a breast examination is a complex skill, the simulator will allow providers to perfect their techniques and become more confident about performing the exam, improving the care for women veterans.

The STAR lab also offers simulation training that helps mental health providers relate to patients with psychiatric disabilities.

“The National Empowerment Center Inc. has designed ‘Hearing Voices that are Distressing’ an audio software program that seeks to provide clinical staff with the opportunity to understand how a patient with mental health issues lives and deals with hearing voices, which helps them to be more empathetic to the veteran that hears voices,” Garrett said.

The training program allows providers to listen to distressing voices via headphones. They then are asked to perform tasks while listening to these voices.
 
“The only difference for the learner and the person with mental health issues is that the learner can take the headphones off and the patient cannot,” Garrett said. “The goal is to change clinical staff’s approach to how we care for persons who hear voices.”

For information about the MEDVAMC, visit Houston.VA.gov.


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