Interprofessional Students Seek and Find Safety Hazards at the Bedside

1. Interprofessional Students Seek and Find Safety Hazards at the Bedside Gretchen Gregory, MSN, RN, Carla Dyer, MD, Sue Boren, PhD; Doug Wakefield, PhD Sinclair School of Nursing , University of Missouri School of Medicine and University Health Care Background The University of Missouri offers a six-hour, four-week interprofessional curriculum in patient safety, quality improvement, and teamwork/communication. The course began in 2003 with an emphasis in patient safety and has gone through many revisions, including the addition of a large scale simulation involving 6 patients with safety issues integrated throughout scenarios in 2009. The Safety Seek And Find Exercise (SSAFE) was developed in 2010 to complement the simulation, heighten the students’ bedside safety awareness and facilitate interprofessional teamwork. Safety Seek and Find Exercise (SSAFE) . Results Individual participants (n=260) identified a range of 3-72% of potential hazards in the SSAFE. Students identified significantly more hazards collaborating as an interprofessional team (range 17-23 of 29) than working independently (mean range 9-13) (p=0.0005 using signed rank test). NEW addition SSAFE “Primer” to simulation Group A Results (continued) Nurses identified 3 more potential safety hazards than other professional groups (13±3; mean + SD) versus (10±3) (p<0.001). NEW addition SSAFE Group A Group B Large Scale Simulation 5 disciplines, 6 patients Interprofessional discussions QI & Safety Staged room -29 safety hazards No Primer Group B Independently identifies safety hazards - SILENTLY Group identification of safety hazards- COLLABORATIVELY Debrief and short reflection Of 12 teams that completed SSAFE twice (Group A), there was no difference in the number of safety hazards identified between time 1 (range 16–23) and time 2 (range 16–24) using the signed ranked test (p=0.1270). There was no significant difference between the mean number of items identified by Group B, completing SSAFE once (19±3: mean+SD), versus Group A, who experienced SSAFE twice (21±2) (p=0.1156). Exposure to SSAFE prior to the large scale simulation showed no advantage as a “primer” to increase students’ recognition of potential hazards in large scale simulation. Purpose of Study 1)To evaluate the effects of SSAFE on the students’ ability to recognize potential safety hazards: a) individually and as a team; and b) within interprofessional groups. 2) To determine optimal frequency and timing of SSAFE in relationship to the existing curriculum. Methods Participants included 260 students from 5 disciplines, divided into 24 groups. Students identified safety issues in a staged hospital room containing 29 safety hazards. The students first identified hazards individually by listing items and then collaborated as an interprofessional team. The students had 20 minutes to complete responses. Twelve of 24 randomly assigned interprofessional small groups experienced SSAFE as a “primer” to increase their awareness of bedside safety hazards prior to their participation in the large scale simulation (Group A). Then all 24 teams experienced SSAFE immediately following the simulation. The “primer’s” impact was evaluated by the students’ ability to recognize safety hazards during the large scale simulation. At course completion, faculty debriefed students on key safety hazards embedded in SSAFE. • Each interprofessional group consisted of: • 5 medical students 4 nursing students • 1 pharmacy student 1 respiratory therapy student • 1 Health Administration graduate student • Conclusions and Implications • SSAFE provided an opportunity to improve students’ ability to recognize safety hazards while enhancing interprofessional collaboration and communication. • Students identified more safety hazards collaborating as an interprofessional team than working independently. • The number of times a student experienced SSAFE and its timing did not impact the students’ ability to identify safety hazards. • SSAFE served as a team building exercise and provided students with environmental safety knowledge. • Many students identified patient safety as a shared responsibility. Acknowledgements: Statistical analysis provided by Bin Ge MD, MA and Youngju Pak, PhD. Additional support provided by Dr. Leslie Hall, the Interprofessional Education Steering Committee, the University of Missouri Center for Health Care Quality, and Dr. Linda Headrick, Senior Associate Dean School of Medicine. *Full list available upon request