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. 2017 Sep:188:258-262.e1.
doi: 10.1016/j.jpeds.2017.03.030. Epub 2017 Apr 20.

The Simulation-Based Assessment of Pediatric Rapid Response Teams

James J Fehr  1 , Mary E McBride  2 , John R Boulet  3 , David J Murray  4
Affiliations

The Simulation-Based Assessment of Pediatric Rapid Response Teams

James J Fehr et al. J Pediatr. 2017 Sep.

Abstract

Objective: To create scenarios of simulated decompensating pediatric patients to train pediatric rapid response teams (RRTs) and to determine whether the scenario scores provide a valid assessment of RRT performance with the hypothesis that RRTs led by intensivists-in-training would be better prepared to manage the scenarios than teams led by nurse practitioners.

Study design: A set of 10 simulated scenarios was designed for the training and assessment of pediatric RRTs. Pediatric RRTs, comprising a pediatric intensive care unit (PICU) registered nurse and respiratory therapist, led by a PICU intensivist-in-training or a pediatric nurse practitioner, managed 7 simulated acutely decompensating patients. Two raters evaluated the scenario performances and psychometric analyses of the scenarios were performed.

Results: The teams readily managed scenarios such as supraventricular tachycardia and opioid overdose but had difficulty with more complicated scenarios such as aortic coarctation or head injury. The management of any particular scenario was reasonably predictive of overall team performance. The teams led by the PICU intensivists-in-training outperformed the teams led by the pediatric nurse practitioners.

Conclusions: Simulation provides a method for RRTs to develop decision-making skills in managing decompensating pediatric patients. The multiple scenario assessment provided a moderately reliable team score. The greater scores achieved by PICU intensivist-in-training-led teams provides some evidence to support the validity of the assessment.

Keywords: education; patient safety; pediatrics; rapid response teams; simulation-based education.

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Conflict of interest statement

The authors declare no conflicts of interest.

Comment in

References

    1. Bonafide CP, Localio AR, Roberts KE, Nadkarni VM, Weirich CM, Keren R. Impact of rapid response system implementation on critical deterioration events in children. JAMA Pediatr. 2014;168:25–33. - PubMed
    1. Brilli RJ, McClead RE, Crandall WV, Stoverock L, Berry JC, Wheeler TA, et al. A Comprehensive Patient Safety Program Can Significantly Reduce Preventable Harm, Associated Costs, and Hospital Mortality. J Pediatr. 2013;163:1638–45. - PubMed
    1. Winters BD, Pham JC, Hunt EA, Guallar E, Berenholtz S, Pronovost PJ. Rapid response systems: a systematic review. Crit Care Med. 2007;35:1238–43. - PubMed
    1. Tibballs J, Kinney S, Duke T, Oakley E, Hennessy M. Reduction of paediatric in-patient cardiac arrest and death with a medical emergency team: preliminary results. Arch Dis Child. 2005;90:1148–1152. - PMC - PubMed
    1. Barry N, Miller KM, Ryshen G, Uffman J, Taghon TA, Tobias JD. Etiology of postanesthetic and post sedation events on the inpatient ward: data from a rapid response team at a tertiary care children’s hospital. Pediatric Anesthesia. 2016;26:504–511. - PubMed

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