Update: Simulation-Based Training

Hospital-Based Simulation

This chapter discusses the current state of hospital-based simulation, including the unprecedented events of 2020's global COVID-19 pandemic. Hospital-based simulation training requires a new approach. The realities of social distancing and the operational demands of hospital staffing ratios warrant creative adaptations of traditional simulation training methods. Hospitals used simulation to improve patient outcomes by training healthcare staff and students through telesimulation, and tested systems and equipment using in situ simulation (ISS). Latent safety threats (LSTs) were identified and corrected to improve patient outcomes. Hospital-based simulation has been incorporated into newly licensed registered nurses (NLRNs) residency programs to prepare them for competent practice. Simulations are also used for preparing staff for low-incidence, high-risk medical emergencies or disasters, such as active shooter events. Hospital-based simulation training adds value to healthcare systems, but requires more evidence of its quantitative and qualitative impacts.

Framework for Critical Care in Obstetrics

In 2015, The American College of Obstetricians and Gynecologists and the Society for Maternal Fetal Medicine issued a joint care consensus document intended to develop standards for designations of levels of maternal care that are complimentary to, but distinct from, neonatal levels of care. Level III and Level IV centers must be prepared to provide obstetric intensive care services. Developing a critical care obstetric program is a resource-intensive process that requires a carefully planned strategic effort essential for successful program implementation and sustainability. In this article, a framework utilizing key components of program development is discussed including environment, scope, model, education and training, maternal transport, and unique aspects of care for women who become critically ill during pregnancy or the postpartum period.