Comparative Cost of Virtual Reality Training and Live Exercises for Training Hospital Workers for Evacuation.

Adoption of virtual reality technology may be delayed due to high up-front costs with unknown returns on that investment. In this article, we present a cost analysis of using virtual reality as a training tool. Virtual reality was used to train neonatal intensive care workers in hospital evacuation. A live disaster exercise with mannequins was also conducted that approximated the virtual experience. Comparative costs are presented for the planning, development, and implementation of both interventions. Initially, virtual reality is more expensive, with a cost of $229.79 per participant (total cost $18 617.54 per exercise) for the live drill versus $327.78 (total cost $106 951.14) for virtual reality. When development costs are extrapolated to repeated training over 3 years, however, the virtual exercise becomes less expensive with a cost of $115.43 per participant, while the cost of live exercises remains fixed. The larger initial investment in virtual reality can be spread across a large number of trainees and a longer time period with little additional cost, while each live drill requires additional costs that scale with the number of participants.

Collaboration Between Academia and Practice: Interprofessional Crises Leadership and Disaster Management.

An innovative interprofessional disaster preparedness program was designed and implemented through an academic-practice partnership between a large midwestern children's hospital and a community-based state university. This course was part of a constellation of courses developed in response to Presidential Directive (HSPD) 8, a mandate to standardize disaster response training that was issued after the inefficiencies following Hurricane Katrina. A hybrid immersive and didactic approach was used to train senior leadership and frontline clinicians. Included were simulated experiences at the National Center for Medical Readiness, a workshop, and online modules. The program that focused on crisis leadership and disaster management was developed and implemented to serve patient-centered organizations.

Effectiveness of positive pressure ventilation during newborn care unit evacuation.

OBJECTIVE: Assess the utility of high fidelity simulation in understanding effectiveness of bag-valve ventilation in a simulated newborn intensive care unit vertical evacuation. PARTICIPANTS: A total of 70 participants, (13 teams of 4-6 staff) including physicians, nurses, respiratory therapists and other support personnel participated in a 90-min evacuation sessions. METHODS: Two wireless high-fidelity newborn mannequins (Gaumand ScientificR) provided real-time data of ventilation support during a NICU evacuation exercise. Trained evaluators also recorded data related to performance. Following the exercises, the simulator data were downloaded and analyzed for rate and consistency of respirations. RESULTS: Using the data from the simulators and evaluator comments, it was found the infants received proper airway management during the evacuation only 58% of the time. This study highlights the need for ongoing training for NICU staff around safe, effective, coordinated, and timely care of these fragile newborns in the event of an evacuation.

Evacuation performance evaluation tool.

OBJECTIVE: Hospitals conduct evacuation exercises to improve performance during emergency events. An essential aspect in this process is the creation of reliable and valid evaluation tools. The objective of this article is to describe the development and implications of a disaster evacuation performance tool that measures one portion of the very complex process of evacuation. DESIGN: Through the application of the Delphi technique and DeVellis's framework, disaster and neonatal experts provided input in developing this performance evaluation tool. Following development, content validity and reliability of this tool were assessed. SETTING: Large pediatric hospital and medical center in the Midwest. PARTICIPANTS: The tool was pilot tested with an administrative, medical, and nursing leadership group and then implemented with a group of 68 healthcare workers during a disaster exercise of a neonatal intensive care unit (NICU). RESULTS: The tool has demonstrated high content validity with a scale validity index of 0.979 and inter-rater reliability G coefficient (0.984, 95% CI: 0.948-0.9952). CONCLUSIONS: The Delphi process based on the conceptual framework of DeVellis yielded a psychometrically sound evacuation performance evaluation tool for a NICU.

Preparing for optimal outcomes: a live evacuation exercise.

Requirements for emergency preparation and training are a part of medical facility guidelines. At one pediatric level I trauma center with 525 beds and more than 12,000 employees, the perioperative teams received regular evacuation training but had never held a live evacuation exercise, so a team made up of perioperative and support personnel created a plan for a live evacuation exercise. The team evaluated the six key areas of evacuation planning: communication, resources and assets, security and safety, staff responsibilities, utilities management, and clinical and patient support activities. Lessons learned from the exercise included the need to include surgeons in evacuation plans, the need for improved communication between different perioperative departments, and the need for security personnel to assist in evacuations.