16POP-UP DELIRIUM SIMULATION TRAINING

Abstract

Topic: There was a failure to adequately recognise, record and respond to a diagnosis of delirium within the Emergency Department (ED) and Acute Medical Unit (AMU). Every additional 48 hours of undetected delirium increases mortality by 11%. We sought to improve clinical skills and staff confidence so that delirium could either be avoided or recognised and better managed. Intervention: Simulation is a cost-effective educational tool advocated in healthcare however delirium cannot be simulated by mannequins. Using NHS improvement methodology, we have developed and implemented Pop-Up Delirium Simulation in ED and AMU using real-life models based on patient experience and observation. Our Older Persons (OPAL) Practitioners use their knowledge and experience to develop scenarios, act out the patient role and facilitate the simulation. Improvement: To date, 96 members of staff have participated in Pop-Up Delirium Simulation training. Outcomes include an average increase of: · 27% in confidence recognising delirium · 33% in knowledge level · 23% in confidence caring for a patient with delirium Delirium screening in AMU with the 4AT has increased from 50% to 82%. 96% of staff rated the teaching methodology and relevance to their work as excellent. "Fab acting! Realistic, better than a SIM man. Holistic care as opposed to focusing just on A & E - thought about collateral and priorities in elderly care. Relevant to ED" Discussion: Our Pop-Up Delirium Simulation model was easy to implement, has been well-received and incredibly successful. It is replicable, flexible and adaptable, quick to set up and run. We have developed further Pop-Up Simulations for dementia in trauma and end of life. Plans are now in place to support other teams to roll out this innovative model into orthopaedic and surgical wards and then the wider community including community hospitals and care homes. Trained simulation facilitators and organisational buy-in are key.