Development of an Innovative Nonanimal Training Model for Infant Pleural Effusion Drainage via Pigtail Catheter Placement.

BACKGROUND: Chest tube placement is an important skill for providers and bedside nurses caring for critically ill infants, allowing for the evacuation of pleural fluid and pneumothoraces. No realistic simulation models are commercially available for trainees to practice and learn this skill on infants. PURPOSE: Our objective was to develop an inexpensive and reproducible model for percutaneous pleural pigtail placement for pleural fluid removal via the Seldinger technique. METHODS: The model was developed using hardware material and a discarded infant resuscitation manikin. The rib cage was constructed using electrical cable wires. Discarded and expired 250-mL bags of intravenous fluids were placed inside the chest cavity to simulate pleural fluid. Shelf liner was wrapped around the chest and abdomen of the infant model to simulate the skin layer. Pediatric critical care faculty performed the procedure on the final model and scored it for realism and utility for teaching. Without including the discarded manikin and fluid bags, the cost of the materials for the model was less than $20. RESULTS: Eight pediatric critical care faculty tested the pleural pigtail placement model. All faculty agreed the model provides a realistic simulated reproduction of placing a pleural pigtail, felt the model was simple to use, and indicated they would use it as a teaching tool in the future. IMPLICATIONS FOR PRACTICE: An effective model for pleural pigtail placement can be inexpensively constructed using discarded bags of intravenous fluid and easy-to-find hardware materials. IMPLICATIONS FOR RESEARCH: Future studies are needed to assess whether this model helps providers and nurses develop and maintain the clinical skills for successful percutaneous pleural pigtail catheter placement.Video Abstract available at https://journals.lww.com/advancesinneonatalcare/Pages/videogallery.aspx?videoId=35&autoPlay=true.

A customizable, scalable scheduling and reporting system.

INTRODUCTION: Scheduling is essential for running a facility smoothly and for summarizing activities in use reports. The Penn State Hershey Clinical Simulation Center has developed a scheduling interface that uses off-the-shelf components, with customizations that adapt to each institution's data collection and reporting needs. METHODS: The system is designed using programs within the Microsoft Office 2010 suite. Outlook provides the scheduling component, while the reporting is performed using Access or Excel. An account with a calendar is created for the main schedule, with separate resource accounts created for each room within the center. The Outlook appointment form's 2 default tabs are used, in addition to a customized third tab. The data are then copied from the calendar into either a database table or a spreadsheet, where the reports are generated.Incorporating this system into an institution-wide structure allows integration of personnel lists and potentially enables all users to check the schedule from their desktop. Outlook also has a Web-based application for viewing the basic schedule from outside the institution, although customized data cannot be accessed. RESULTS: The scheduling and reporting functions have been used for a year at the Penn State Hershey Clinical Simulation Center. The schedule has increased workflow efficiency, improved the quality of recorded information, and provided more accurate reporting. CONCLUSIONS: The Penn State Hershey Clinical Simulation Center's scheduling and reporting system can be adapted easily to most simulation centers and can expand and change to meet future growth with little or no expense to the center.