Medical Emergencies in the Primary Care Setting: An Evidence Based Practice Approach Using Simulation to Improve Readiness

Abstract

Background: Simulation is an evidenced based strategy which has been shown to impact office-based readiness to respond in a medical emergency. Medical emergencies occur in the primary care setting on a less frequent basis than in the inpatient setting. Clinicians working in primary care may benefit from an opportunity to refresh their skills.

Methods: This descriptive pre and post survey design evidenced based project examined staff reported levels of competence and confidence when responding to an emergency in a pediatric primary care office. Simulation educators partnered with ambulatory nursing and medical leaders to create a mock code program for staff in a care network. During a 14-month period, simulations were conducted in 30 primary care sites. Staff completed pre- and post-simulation surveys to assess levels of confidence in decision-making skills and competence when managing medical emergencies.

Findings: A statistically significant increase in the mean scores for both confidence and competence was demonstrated when comparing pre- and post-simulation survey results.

Discussion and application to practice: Simulation as an educational technique resulted in an increased level of competence and confidence of primary care office staff to respond to an emergency. Additionally, staff developed an overall heightened awareness of emergency processes and recognized of the value of simulation as an educational tool.

Keywords: Emergency preparedness; Inter-professional education; Pediatrics; Primary care; Simulation.