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Instilling Confidence and Competence: CRRT Training and Troubleshooting in the Simulation Lab Vickie Hawkins . Background. CRRT @ Cardon Children’s PICU Low Volume/High Risk Skill Previous experience Patients transferred to other facilities No continuity of patient care

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  1. Instilling Confidence and Competence: CRRT Training and Troubleshooting in the Simulation LabVickie Hawkins

  2. Background • CRRT @ Cardon Children’s PICU • Low Volume/High Risk Skill • Previous experience • Patients transferred to other facilities • No continuity of patient care • Decreased RN confidence • Decreased MD confidence • The education “fix” at the time • Training from company educators • Tech support from company • Practice • Support from adult ICU Legend: NE: no experience RMH: run machine with help RM: run machine without help ET: Basic training AT: Advanced training

  3. The Road from Then to Now • Goals • Core group of PICU staff • Set-up and Troubleshoot • 30 minute set up time • Access • Clotted Filter • Initiation and Disconnect • Improve confidence levels • Assist with future education & training • Resources • Evidence-based education lacking for CRRT • Simulation shown to assist learners transition skills into practice

  4. Simulation • Logistics • Cost • Schedules • Equipment • Develop curriculum • Weighted Checklists • Eight hour didactic session • Three 4-hour based simulations • Mandatory monthly 4-hour simulation session • Simulation • Use of saline in simulation not satisfactory to replicate troubleshooting • Develop tubing to accommodate blood • Create scenarios

  5. Outcomes • Remediation decreased as the skill level of the nurse increased Time to Set Up Goal: less than 30 minutes

  6. Confidence Levels Increased Nursing self-confidence increased significantly Physician confidence increased significantly

  7. Process replicated 6 months later

  8. Thank you

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