In 2009, a national simulation training and education program was established for the Veterans Health Administration (VHA) called SimLEARN to provide simulation-based learning strategies to help the clinical workforce use technology to enhance their training. Clinical simulation has become part of the culture at the San Francisco VA Medical Center for staff training, process evaluation and improvements, as well as dealing with safety issues.
According to the SimLEARN winter newsletter, the first cardiopulmonary perfusion simulator was just installed at the VA Medical Center in San Francisco. It will help the perfusionist which is a specialized healthcare professional use the heart-lung machine during cardiac or other surgeries.
The perfusion simulator is able to connect directly to clinical monitoring equipment. The equipment makes it possible to interface with the clinical cardio-pulmonary bypass machine to provide realistic screen displays and actual physiologic waveform data to the perfusionist, anesthesia provider, and the surgical team.
In another part of the country, the staff at the Durham VA Medical Center (DVAMC) has been successful at finding, reporting, and fixing medical threats throughout the hospital as a result of its Code Response Team (CRT) simulation training program. These unannounced simulations are held all over the hospital involving first responders and actual code team members responding to a simulated cardiac arrest.
Using simulation with stroke patients has indicated that certain tools and supplies are needed for stroke care can differ from what is needed for other rapid response situations and codes. The simulation team involved in stroke care has taken a standardized patient through the entire process from entry to the facility through the administering of tPA.
The simulation team collaborates with the stroke program coordinator, ICU, ED nurse educators, ED management, patient safety officers, clinical nurse specialists, and pharmacy supervisors to simulate and document the process.
The team has developed a stroke specific lab pack, the NIH stroke scale, and other items. The team also developed a bedside cognitive aid to assist the staff in completing necessary processes when a possible stroke is identified. This aid is readily available on all units, and has been reworked and updated several times in response to continued simulation training.