Enhancing Endoscopy Nursing Through Simulation Practices
Endoscopy nursing relies on effective teamwork, especially in rare emergency situations. Simulated practices provide a safe space for nurses to improve their skills and situational awareness. This article highlights the benefits of simulation in endoscopy nursing education, focusing on familiarizing with emergencies, enhancing patient care, and developing crucial skills for managing complex scenarios.
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Simulation in endoscopy Nursing and beyond. Conor Hamilton (Lecturer (Education)- Nursing QUB) c.hamilton@qub.ac.uk
Background Endoscopy is dependent on effective team work - evident in emergency situations. Emergencies in endoscopy are rare: Endoscopy nurses need to have knowledge & skills to act in these situations. Rarity of emergency scenarios leads to deskilling in their management. Innovation & increased ability to perform complex interventions increases the risk Simulated practice allows nurses to work together in the knowledge that they are within the safety of a non-clinical environment. Simulation improves non-technical skills and increases situational awareness. The short course in endoscopy nursing provides students with a connected approach to learning of which simulation is one pedagogical approach. Simulation provides an immersive experience patient experience and team member roles. essential in the provision of person-centered care in an endoscopy emergency.
Purpose Familiarise with endoscopic emergencies & challenging situations. Appreciate the patient and team member experience . Positive results from simulation - student/module feedback. Realism . Safe space . Confidential debrief (PEARLS Healthcare debriefing tool). (Bajaj et al. (2017)The PEARLS Healthcare Debriefing Tool. Acad Med.)
Scenarios Local toxicity (simulated patient) Signs/symptoms of severe toxicity . Immediate management of a patient with severe local anaesthetic toxicity . Treatment . Follow up . Cardiac arrest (mannequin) Recognition of deteriorating patient. Team communication. Managing resuscitation. Aggressive patient (simulated patient) Communication and management complaints procedure. At present unable to simulate bleeds and perforations.
Skills needed for acquiring competency in gastrointestinal (GI) endoscopy Current Simulation capability What we want to add. Classroom based mostly theory. JAG Basic Skills. Skills needed for acquiring competency in gastrointestinal (GI) endoscopy adapted from Walsh et. al. (2016
Looking forward my vision Extend simulation to include authentic equipment and endoscopy simulators . Involvement of Service Users who currently engage in classroom sessions to expand into our simulation practices. Extend SIM capability for Nursing (CPAD). Add SIM capability for Medicine. (Dr. Andrew Spence). Develop interprofessional simulation exercises (Dr. Andrew Spence). Currently endoscopist s first training scope on a live patient pt. comfort low. With simulated practice patient comfort & satisfaction are improved earlier. QUB as a hub for JAG accredited Basic Skills (Upper & Lower) SIM only JAG Endoscopic simulator course.
JAG Endoscopic simulator course Endoscopy - elearning for healthcare (e-lfh.org.uk) (prerequisite) Core Endoscopy for Endoscopists Consent. Sedation. Pathology recognition. Endoscopic Non-technical skills (ENTS) Respiratory Depression: Communication, Teamwork & Leadership . Perforation in Endoscopy: Situational Awareness & Judgement and Decision Making . Upper GI Bleed: ENTS in Action . Learning pathways: Basic skills Colonoscopy. Oesophago-Gastro-Duodenoscopy (OGD). Flexible Sigmoidoscopy.
JAG Endoscopic simulator course Endoscopic simulator course (JAG_BDM1) Target audience F2, CT1 and CT2 Trainees who are interested in Gastroenterology / Surgery but have no scoping experience before they apply for ST3 level .. AND Trainee Nurse Endoscopists. Duration 1 day. Overview: This course acts as an introduction to Endoscopy Training. Aimed at trainees before they apply for a ST3 post this course gives the individual an understanding of scope manipulation and basic correct technique. SIM allowed for Basic skills sign off.
JAG Endoscopic simulator course Aim extend to Basic Skills Colonoscopy, Flexible Sigmoidoscopy, OGD, ERCP. All include SIM (model), animal (?) and patients. SIM aspect delivered in QUB . Patient endoscopy in BCH/RVH with faculty staff as training list . Collaborative approach: Faculty from QUB and Trust.
Does Endo SIM work? Similar to the model I trained on in DHH. Used this until my dexterity and scope handling improved. Approx. 50 intubations to caecum. Followed by 12 live colonoscopies. JAG Basic skills course in Altnagelvin live colonoscopies on a training list. My practice was as good as other trainees with 100+ live supervised colonoscopies.
Where to now? Site visits information gathering This presentation has come a week too soon for me: This week RCSI Dublin met Miroslav and Leonie to discuss equipment, scenarios and site visit. Next week: Visit LJMU - view Olympus funded endoscopy simulation suit (JAG approved). Visit UCC to share ideas on setting up simulated endoscopy capability. NUIG visit to be confirmed similar visit to UCC. Collaboration to gather best of all sites for use in planning QUB endoscopy simulation for Nursing, Medical and IPE. and the pipedream JAG accredited Basic Skills training.
LJMU/ Olympus partnership proof of concept Olympus partnership to train more professionals in cancer screening | Liverpool John Moores University (ljmu.ac.uk) LJMU s School of Nursing and Allied Health has worked with the Mersey School of Endoscopy to become one of the leading centres in training NHS professionals in endoscopy. The School has just installed two state-of-the-art endoscopy stacks provided by Olympus as part of an established partnership, which also sees Olympus train technicians and share educational materials for students. We deliver all the taught sessions and simulated practice here at LJMU which relieves pressure on the hospital and means we can teach larger groups. (1) Endoscopy Training: LJMU and Olympus train workforce to screen for cancer YouTube Susan Baker | Liverpool John Moores University (ljmu.ac.uk)
Proposal SIM suite in QUB possible income. JAG Endoscopic simulator course eventually JAG Basic skills course. Faculty BCH/RVH and regional NEs requirements (JAG TTT). 2 stacks 2 scopes (Olympus funded) - no need for decon. High fidelity simulators automated response and feedback. NE/Medical training improved dexterity before first live patient. Improved patient comfort and experience. Nursing simulated scenarios upskill & prevent deskilling. IPE joint training sessions improve IP communication in endoscopy. Endoscopy emergencies rare deskill between. SIM could reduce this.
References Walsh C.M. (2016) Best Practice and Research: Clinical Gastroenterology. Bailliere Tindall Ltd.; Kent, UK: Jun 1, 2016. In-Training Gastrointestinal Endoscopy Competency Assessment Tools: Types of Tools, Validation and Impact; pp. 357 374. Bajaj K, Meguerdichian M, Thoma B, Huang S, Eppich W, Cheng A. (2017).The PEARLS Healthcare Debriefing Tool. Acad Med. NHS England (2023) elearning for healthcare. Available at Endoscopy - elearning for healthcare (e-lfh.org.uk) Accessed 05/05/2023 Joint Advisory Group on GI endoscopy (2023). Available at JAG (thejag.org.uk) Accessed 05/05/2023 Liverpool John Moores University (2023) Olympus partnership to train more professionals in cancer screening | Liverpool John Moores University (ljmu.ac.uk) Accessed 05/05/2023
