As VUSN student Abbie Smith documents the interaction (foreground), Lauren Smith, left, and Randy Smith administer CPR while Leslye Stewart (background) intubates a simulated patient experiencing a pulmonary embolism as a part of rapid response training. (photo by John Russell)
VUSN ramps up training for rapid response teams
Vanderbilt University School of Nursing is bringing students, faculty and simulation technology together as never before to train nursing students to be future members of rapid response teams.
Organizations such as the Institute for Healthcare Improvement have challenged health systems to improve patient safety, in part by establishing rapid response teams aimed at helping patients who are swiftly failing in units outside the intensive care unit.
Various studies have shown that these teams can reduce cardiac arrests outside the ICU by 50 percent, reduce post-surgery problems by 58 percent and decrease transfers to more complex care by 30 percent.
Vanderbilt has continued to see benefit from its own rapid response teams, which include both registered nurses and intensivist nurse practitioners.
VUSN is giving students a first-hand experience of dealing with patients with rapid clinical deterioration during joint intra-disciplinary simulations.
Students assume the role of bedside nurses assessing a given patient, focusing on when to call a “rapid response” and how to interact with the rapid response team. Acute care nurse practitioner intensivist students focus on team leadership, diagnostics and interventions. The entire group works together to stabilize the patient.
“It’s a situation that happens several times every day with real patients in hospital settings across the country,” said Sally Miller, MS, R.N., VUSN Skills and Simulation Lab Manager. “With simulation, students get an immersion experience complete with the urgency, adrenaline rush and communication issues, but in a safe setting.”
In the simulated experience, a computerized mannequin is programmed in a series of unfolding scenarios. Based on the student’s response, instructors are able to observe the interaction and modify the mannequin’s vital signs and other physiological responses.
“It’s nice to practice in this setting, to see how things run rather than something we’ve just read about in a textbook,” said VUSN student Heather Sevcik.
After each of the 25-minute scenarios in VUSN’s Simulation Lab, the students do a quick debriefing and then move on to two additional scenarios. At the end of all three scenarios, the entire group participates in a comprehensive debriefing session.
“The students assuming the role of the bedside nurse learn how to identify patients whose illness is progressing rapidly and when to call for a rapid response team for support,” said Josh Squiers, MSN, ACNP Intensivist program coordinator.
“Students leading the rapid response team learn how to manage an emergency team and learn to work with non-critical care nurses during an emergency situation, something crucial to being effective.”
“It takes a lot of practice to be calm during a situation like that,” said Molly Goidel, a Medical Intensive Care R.N. and acute care nurse practitioner student, after a simulation for a 34-year-old pulmonary embolism patient. “We learn too, because we are walking into a situation where we don’t know the nurses and that’s more how it is when this happens in real life.”
From the faculty perspective, Squiers and Miller have seen how the simulation experiences are shaping the students’ education, including recent positive feedback from providers who have seen the students in action in clinical settings.