Simulation-based education to improve management of refractory anaphylaxis in an allergy clinic

Allergy, Asthma & Clinical Immunology

Research

Mohamed Badawy¹  Arnaud Robitaille²  Matthieu Vincent³  David Claveau⁴  Rémi Gagnon⁵  Jean Paradis⁶  Anne Des Roches⁶  Ana M. Copaescu⁷  Philippe Bégin⁸  Francois Graham⁸  Nathalie Nadon⁹ 

[1] Department of Anesthesiology, Montreal Neurological Institute and Hospital, Montreal, QC, Canada;Department of Anesthesiology, Université de Montréal, Montreal, QC, Canada;Department of Emergency, Hôpital Charles-Le Moyne, Université de Sherbrooke, Greenfield Park, QC, Canada;Department of Emergency, CHU Sainte-Justine, Université de Montréal, Montreal, QC, Canada;Department of Emergency, Université de Montréal, Montreal, QC, Canada;Department of Medicine, Allergy-Immunology Division, Université Laval, Quebec, QC, Canada;Department of Medicine, Allergy-Immunology Division, Université de Montréal, Montreal, QC, Canada;Department of Medicine, Allergy-Immunology Division, Université de Montréal, Montreal, QC, Canada;Department of Medicine, Division of Allergy and Clinical Immunology, McGill University Health Centre (MUHC), McGill University, Montreal, QC, Canada;Department of Medicine, Université de Montréal, Montreal, QC, Canada;Department of Medicine, Allergy-Immunology Division, Université de Montréal, Montreal, QC, Canada;Department of Medicine, Université de Montréal, Montreal, QC, Canada;Learning and Simulation Center, CHUM Academy, Montreal, QC, Canada;

关键词: Medical education;    High fidelity simulation based-learning;    Anaphylaxis;    Allergic emergencies;    Anaphylaxis management;    Teamwork;    Allergy clinic;    Ambulatory setting;   

DOI  :  10.1186/s13223-023-00764-9

 received in 2022-07-22, accepted in 2023-01-14,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundHigh-fidelity simulations based on real-life clinical scenarios have frequently been used to improve patient care, knowledge and teamwork in the acute care setting. Still, they are seldom included in the allergy-immunology curriculum or continuous medical education. Our main goal was to assess if critical care simulations in allergy improved performance in the clinical setting.MethodsAdvanced anaphylaxis scenarios were designed by a panel of emergency, intensive care unit, anesthesiology and allergy-immunology specialists and then adapted for the adult allergy clinic setting. This simulation activity included a first part in the high-fidelity simulation-training laboratory and a second at the adult allergy clinic involving actors and a high-fidelity mannequin. Participants filled out a questionnaire, and qualitative interviews were performed with staff after they had managed cases of refractory anaphylaxis.ResultsFour nurses, seven allergy-immunology fellows and six allergy/immunologists underwent the simulation. Questionnaires showed a perceived improvement in aspects of crisis and anaphylaxis management. The in-situ simulation revealed gaps in the process, which were subsequently resolved. Qualitative interviews with participants revealed a more rapid and orderly response and improved confidence in their abilities and that of their colleagues to manage anaphylaxis.ConclusionHigh-fidelity simulations can improve the management of anaphylaxis in the allergy clinic and team confidence. This activity was instrumental in reducing staff reluctance to perform high-risk challenges in the ambulatory setting, thus lifting a critical barrier for implementing oral immunotherapy at our adult center.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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Fig. 1

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