Recognising and responding to acute patient deterioration in the perioperative environment – A simulation-based learning approach to meeting National Healthcare Standards criteria

Abstract

Background
Deterioration in acute healthcare settings is associated with serious adverse sequelae. A National Standards framework for healthcare facilities in Australia has mandated that such facilities provide evidence that satisfies criteria relating to acute deterioration recognition and response. Whilst education and training of healthcare practitioners have been prominent since National Standards inception, state-wide mandatory training programs have not been sensitive to the perioperative context.
Aim
To evaluate the effectiveness of a perioperative simulation-based learning program in building capacity for perioperative staff in acute patient deterioration recognition and response.
Methods
A multiple group post-test design using quantitative measures was undertaken. Participants were a consecutive sample of perioperative nursing staff (n=56) employed across three hospitals in Sydney who self-enrolled in simulation-based learning workshops. Each six-hour workshop focussed on four acute deterioration scenarios: Anaphylaxis, Malignant Hyperthermia, Post-Partum Haemorrhage, and Local Anaesthetic Systemic Toxicity. Simulation effectiveness was measured using the 19-item Simulation Effectiveness Tool–Modified. Descriptive statistics were calculated, and qualitative content analysis was used for an open-ended question.
Findings
All 19 items elicited a high degree of ‘strongly agree’, ranging from 57.1% to 89.6%, with only four of the 19 items achieving less than 80% ‘strongly agree’. Content analysis generated two primary categories: ‘Self-efficacy enabling professional autonomy’ and ‘Relevant and authentic representation’.
Discussion
Perioperative simulation-based learning can enhance clinical proficiency and professional autonomy, whilst developing clinical reasoning, teamwork, and delegation skills.
Conclusion
Perioperative simulation-based learning was perceived as effective in preparing nursing staff working in the perioperative specialty for real-world clinical emergencies.