Development and evaluation of a high-fidelity, multi-disciplinary simulation training course for high-consequence infectious diseases using fluorescence visualization

IF 3.9 3区医学 Q1 INFECTIOUS DISEASES Journal of Hospital Infection Pub Date : 2024-12-26 DOI:10.1016/j.jhin.2024.12.008

L. Hunt , J. Cole , C. Evans , S. Farrow , P. Johnson , C. Bailey , P. Lewthwaite , P. Lillie , S. Lukins , C. Mace , G. Mountford , M. Rumbold , M. Ankcorn , N. Easom , A. Tunbridge , B. Crook , the UK High Consequence Infectious Disease Network

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Abstract

Background

High-consequence infectious diseases (HCIDs) include contact-transmissible viral haemorrhagic fevers and airborne-transmissible infections such as Middle Eastern Respiratory Syndrome. Assessing suspected HCID cases requires specialized infection control measures including patient isolation, personal protective equipment (PPE), and decontamination. There is need for an accessible course for NHS staff to improve confidence and competence in using HCID PPE outside specialist HCID centres.

Aim

To produce and evaluate a training course for National Health Service (NHS) staff on recognition and assessment of patients with suspected HCID infection.

Methods

We developed a multi-disciplinary course blending online learning with in-person, high-fidelity simulation using a manikin which employs fluorescent tracers to simulate airborne, contact, and fomite transmission. This facilitates visualization of contamination pre- and post-PPE removal and supports team-based debrief of performance. Training culminated in competency-based assessment. Educational effectiveness was evaluated through curriculum-linked pre- and post-course tests, and self-rated confidence using Likert scales.

Findings

Between December 2022 and April 2024 180 nurses, specialty registrars and consultants were trained. Educational effectiveness was evaluated in 60 consecutive participants between December 2022 and April 2023. Pre- and post-course assessments revealed significant improvements in knowledge (mean score 61% vs 83%, P<0.0001). Pre-course, 36% of learners reported feeling confident in HCID PPE donning and doffing, rising to 97% post-course. Participants unanimously rated the learning experience as high- or very-high quality.

Conclusion

This course, incorporating ultraviolet markers for contamination visualization, represents a novel approach outside military settings. The results demonstrate its effectiveness as an educational intervention, improving staff confidence and competence in PPE use.

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开发和评估高保真，多学科模拟训练课程，为高后果的传染病使用荧光可视化。

背景：高后果传染病（HCID）包括接触传播的病毒性出血热和空气传播感染，如中东呼吸综合征。评估疑似HCID病例需要专门的感染控制措施，包括患者隔离、个人防护装备（PPE）和去污。有必要为NHS工作人员提供一个可访问的课程，以提高在专业HCID中心之外使用HCID PPE的信心和能力。目的：为NHS工作人员提供识别和评估疑似HCID感染患者的培训课程。方法：我们开发了一门多学科课程，将在线学习与现场高保真仿真相结合，使用使用荧光示踪剂的人体模型来模拟空气传播、接触传播和污染物传播。这有助于可视化ppe移除前后的污染情况，并支持基于团队的绩效汇报。培训的高潮是基于能力的评估。通过与课程相关的课前和课后测试评估教育效果，并使用李克特量表自我评定信心。结果：在2022年12月至2024年4月期间，培训了180名护士、专业注册师和咨询师。在2022年12月至2023年4月期间，对60名连续参与者的教育效果进行了评估。课程前和课程后的评估显示知识有了显著的提高（平均得分61%对83%）。结论：他的课程采用紫外线标记进行污染可视化，代表了军事环境之外的一种新方法。结果表明，它作为一种教育干预措施，提高了员工对PPE使用的信心和能力的有效性。

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来源期刊

Journal of Hospital Infection 医学-传染病学

CiteScore

12.70

自引率

5.80%

发文量

271

审稿时长

19 days

期刊介绍： The Journal of Hospital Infection is the editorially independent scientific publication of the Healthcare Infection Society. The aim of the Journal is to publish high quality research and information relating to infection prevention and control that is relevant to an international audience. The Journal welcomes submissions that relate to all aspects of infection prevention and control in healthcare settings. This includes submissions that: provide new insight into the epidemiology, surveillance, or prevention and control of healthcare-associated infections and antimicrobial resistance in healthcare settings; provide new insight into cleaning, disinfection and decontamination; provide new insight into the design of healthcare premises; describe novel aspects of outbreaks of infection; throw light on techniques for effective antimicrobial stewardship; describe novel techniques (laboratory-based or point of care) for the detection of infection or antimicrobial resistance in the healthcare setting, particularly if these can be used to facilitate infection prevention and control; improve understanding of the motivations of safe healthcare behaviour, or describe techniques for achieving behavioural and cultural change; improve understanding of the use of IT systems in infection surveillance and prevention and control.