- Associated Press - Monday, April 21, 2014

MUNCIE, Ind. (AP) - nside an IU Health Ball Memorial Hospital room, hospital staffers trade off performing chest compressions on a man lying in a hospital bed.

Afterward, they gather in the room next door to watch video of their efforts filmed by two cameras mounted overhead and played back on a screen that also displays the patient’s monitor throughout. An instructor points out mistakes visible in the playback, such as someone’s arms held at the wrong angle while doing compressions, and a pause of longer than 10 seconds before beginning the next round.

After offering their own critiques and observations, the group files back into the hospital room to gather around the patient’s bed and try it all again.

Thankfully, the setting isn’t actually inside the hospital itself, and the flatlining “patient” in question is a mannequin and is in no danger; the exercise is part of a class being taught in the Janice B. Fisher Learning Center, a new facility providing simulation technology and mannequins for training new and current IU Health BMH employees. An open house for the public is scheduled for Thursday, The Star Press reported (https://tspne.ws/1reRXdz ).

The space in the basement of the Edmund F. Ball Medical Education Center includes not just offices for the hospital’s Education Resources program, plus classrooms and computer labs, but also three simulation rooms built to mimic specific areas of the actual hospital.

Two of them are replicas of rooms in the hospital’s South Tower, with a nurse’s station in the hall providing windows into a patient room on either side, and the same storage, beds and equipment used in the hospital itself.

A third simulation room matches a trauma room in the hospital’s Emergency Department, down to the carts filled with supplies and the sink installed where it would be in the ED, even though this one isn’t actually hooked up to a water line, noted Joni Casperson-Bates, simulation coordinator for the center.

In addition to learning procedures and skills in a space that exactly mimics what they’ll find on the job, students at the learning center also use highly sophisticated mannequins that can be made to breathe, bleed, choke and even answer questions.

The center’s high-tech mannequins include a newborn, a toddler, a child and several adults. They can be programmed to have labored breathing, suffer bleeding or even amputated limbs or turn blue around the lips from a lack of oxygen, all while their vital signs are shown on a monitor, as with a regular human patient. They can have tubes put down their throats or IV’s hooked up, and can be “revived” with a working defibrillator; the female mannequin can even “give birth.”

The “sim-patients” can even answer the health care provider’s bedside questions, either with preprogrammed responses or by having an instructor “talking” for the patient from the next room. Casperson-Bates demonstrated with the child mannequin, known as Junior, using a small tablet to make him cough, moan with pain, answer “Yes” to a question or make gagging noises.

Having the realistic simulation experience allows health care staffers to practice skills or learn a specific routine in a safe setting, learning center officials said. “They can possibly fail with a mannequin and not with a real person,” Cyndi Davisson, director of professional development, said.

Each simulation room has a control room for the instructors outfitted with computers to run the simulation and one-way glass so they can observe the students but the students can’t look to them for a reaction, Casperson-Bates said.

The cameras mounted in each of the simulation rooms give those taking the training a chance to see exactly what they did rather than just going by memory. Having people critique their own performance based on the video is a great teaching tool, according to Davisson. “The whole debriefing is where the learning occurs,” she said, adding the simulated scenarios are “always much better the second time.”

The new facility is named after the late philanthropist Janice Fisher, who in 2011 left the IU Health Ball Memorial Hospital Foundation $1 million to use for graduate education and $1 million in unrestricted funds, according to foundation President Tricia Stanley. The unrestricted funds portion of the gift went to the learning center, allowing the Education Resources program to move from a few rooms in the basement of nearly-80-year-old Maria Bingham Hall to the several times larger, custom-designed, state-of-the-art facility just across Gilbert Street.

Though foundation officials did not know at the time Fisher’s gift was announced exactly where those funds would go, when hospital officials were asked about how the funds might be used, they quickly identified a new education facility like this one, Stanley said. Members of Fisher’s family were overwhelmingly supportive of the idea as well, she added.

This sort of facility might be on a hospital’s wish list, but might well not have come into being without funding from a planned gift like Fisher’s, Stanley noted.

Before the new center opened, such lessons were taught mainly by talking through a scenario and using PowerPoint presentations, maybe having a re-enactment of sorts set up in a conference room, according to Davisson and Casperson-Bates.

The Education Resources department is actually part of the nursing division, but all departments at the hospital can and are using the new center or looking at doing so. “This learning center is for the whole hospital,” Davisson said.

New nurses can use it to practice checking a patient in; medical residents can practice emergency scenarios; cleaning staff can practice how to clean a patient room properly.

Scenarios can be set up and mannequins programmed to mimic “things that rarely happen” so medical residents have some idea of how to handle them before potentially encountering such a critical situation in real-life-and-death circumstances, Casperson-Bates said.

Dianne Lynch, nursing professional development educator, noted the simulation rooms and scenarios give new nurses a valuable chance to practice skills in “real life” after learning about them in the classroom, but still without the pressure of having a doctor or other patients waiting.

Similarly, interdisciplinary groups including nurses, residents and other staffers can go through scenarios together and then use the video to examine and critique their communications and interactions in ways that don’t happen on the real hospital floor, Davisson said: “It really opens up the lines of communication.”

Departments can use the facility to train staffers in standardized procedures by having them go through the steps and then analyze their performance on video, Casperson-Bates said. The center buys some scenarios ready-made but can develop others in-house to specifications.

Hospital departments are already taking advantage of the potential uses of the learning center, which has been up and running since early February. “Our usage has been more than we expected,” Casperson-Bates added.

The medical residents program is “using this as a recruiting tool,” Davisson said.

In addition to being used by hospital medical staffers and students, the learning center will also be used for birthing and CPR classes. Meanwhile, the public open house on Thursday will allow people to “see what a tremendous community resource this is,” Stanley said.


Information from: The Star Press, https://www.thestarpress.com

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