The Bristol Medical Simulation Centre was the first of its kind in the UK when it opened in 1997, and has gone from strength to strength ever since. This article lets you learn about the work of the centre including helping staff train for the new developments at UH Bristol.
“We will train anybody: nurses, doctors, allied health professionals, patients and parents,” says Caroline Box, paediatric simulation coordinator at The Bristol Medical Simulation Centre (BMSC). And staff at the centre have been doing exactly that for 17 years. Through their advanced training courses and sophisticated equipment and facilities, they have cemented the centre’s reputation for innovation and excellence. Recently, the centre and its staff have been playing a pivotal role in helping employees from UH Bristol prepare for major changes. Caroline says: “As part of the transfer of specialist paediatric services from North Bristol NHS Trust, we were tasked with providing simulation training for the multi-professional teams that were transferring over. We started the process before the move by visiting staff at Frenchay Hospital and working with them to familiarise ourselves with their practice and improve their understanding of the practices and procedures at the children’s hospital.”
Testing new facilities
Even though a huge amount of thought and effort has gone in to the design and build of new facilities at the Bristol Royal Hospital for Children and the helideck on the roof of the Bristol Royal Infirmary, it was essential to test their suitability and level of safety for patient care. “We had to ensure that the helipad, hospital corridors and the lifts were suitable for patients. So we tested the pathway by using our manikin dressed as a major trauma patient. The manikin was put in the helicopter while it was on the helideck and then we simulated what would happen if it was a major trauma patient brought in by helicopter.” The team had to remove the ‘patient’ from the aircraft, along with all the equipment. To make the simulation as real as possible, the patient was intubated, allowing the team to run through what the respective roles of the porters and helicopter doctor would be. Once off the aircraft, the patient was wheeled down to the lift, and transported through the hospital to the children’s emergency department. “You might say, ‘Why not just walk the routes?’” says Caroline, “but it’s completely different with a patient, and that’s why we do it with the manikin. For example, the helideck crew may not have experience of handling medical equipment outside of the helicopter with the patient, so that is why we did it. “What we did with the helicopter was really interesting and useful – for me it’s the bridge between theory and working with patients. It’s a way of everyone practising not just skills but how we work.”
The team’s work at the children’s hospital included running simulations for taking patients to the new CT scanner – finding out how best to get a patient into the scanner and whether the trolleys carrying the patients could be manoeuvred easily. They also worked closely with the emergency department, in preparation for the children’s hospital becoming a designated paediatric major trauma centre. Caroline says: “We used the manikins – brought them in through the emergency department doors with the paramedics and put a call out for the trauma team. It allowed everyone to test their responses and ensure everyone knew what they were supposed to be doing and where to go.”
The training on offer at the centre covers two main strands – simulation training in the centre, and point of care training, where Caroline and her colleagues take a manikin to a ward and simulate caring for a patient with a certain condition in the environment where the staff are used to working. Using the sophisticated computer controlled manikins and the facilities at BMSC – which can be set up to simulate a ward, an operating theatre or even the patient care compartment of an ambulance – the team provides training for the full range of healthcare professionals including surgeons, anaesthetists and operating theatre support staff – including training newly qualified paediatric nurses and paediatric nurses new to UH Bristol. “Newly qualified paediatric nurses get two days of nurse education and then one day of simulation,” says Caroline. “We run a wide variety of courses including a key competency course for doctors. There is a fifth year medical student day to help them make the transition from being students to being qualified. We can support individual areas by running specialist training days designed for that area. “We also do training around human factors – communication, leadership and teamwork. In addition, we deliver faculty development courses where we train people in the skills of delivering simulation-based education and training. These involve training individuals in the skills of designing, delivering and debriefing simulation scenarios and courses. “That’s what we do,” adds Caroline. “It’s a great job!