Implementation of Simulation-based Mock Drill Malignant Hyperthermia in an Acute Healthcare System

Purpose: : The purpose of this project is to develop and implement a simulation program to establish safe, effective, and efficient evidence-based care of Malignant Hyperthermia patients in an acute healthcare system. Joint Commission and Center for Medicaid and Medicare Services (CMS) standards require staff in procedural and recovery areas to be trained in the early identification and management of Malignant of Hyperthermia.

Design: :

Method: This innovated education/program involved:
• Staff education
• Simulation-based training
• Pre and Post test
• Debriefing
• Outcome evaluation

• The regional educators reviewed the following: literature specific to simulation–based training for mock drill malignant hyperthermia. Guidelines in the assessment and management of malignant hyperthermia were obtained from MHAUS.
• The team established simulation-based training guidelines for mock drill MH and competencies to be evaluated.

Setting:: Multiple, private, community hospitals in California belonging to one healthcare system. Departments that participated included: Perioperative, Emergency department, and Labor & Delivery. Procedural and recovery units were identified in several acute hospitals as training sites and were scheduled on a month-to-month basis of education planning. Staff participants included: physicians, staff RNs, OR Techs, RCP, Lead RNs, and educators.

Sample:: Staff participants included: physicians, staff RNs, OR Techs, RCP, Lead RNs, and educators. Convenience sample of staff from various departments who were working were selected.

Methods: : The mock code simulation was designed to enhance assessment and management skills of staff in the care of patient exhibiting signs and symptoms of Malignant Hyperthermia.

Participants were individually given a standardized pre-test of knowledge before education session and simulation. An education session was conducted followed by mock drill/simulation testing using a medium-fidelity human simulator. A Mock Drill Evaluation skills checklist was utilized to evaluate participants during simulation of Malignant Hyperthermia scenarios. A standardized 10-item multiple choice questions (pretest and posttest) were administered. Data analysis and interpretation were performed using paired t test.

Results: : • There were 31 staff members from ED, OR, and L&D that voluntarily participated in the simulation process. The pre-tests score consisted of a knowledge mean score of 6.97 and the post-tests with a knowledge mean score of 9.87 Data showed statistical significance at p=0.0001. A significant increase in knowledge were noted among staff members post simulation. Staff members rated increased self-confidence and overall experience with the mock code simulation.

Comments:
“I think we should continue to do this more often!!
“Great practice! Continue with more mock codes.”
“Great experience- need to have these mock codes more often.”
“Excellent – I really value doing this code.”

Implications:: • Mock Code MH Simulation can improve knowledge and skills acquisition of nurses, physicians, and techs in the ED, OR, or L & D in the Management of Malignant Hyperthermia