The role of simulation-based training to improve team performance in implementing one-hour sepsis bundle: a randomized trial

Abstract

Background: Excellent team performance is one of the keys in managing patients with sepsis successfully. Simulation-based training with high fidelity manikin (HFM) is one of the many ways to enhance team performance. This study aims to compare the role of simulation-based training with HFM with conventional method to improve team performance in conducting one-hour sepsis bundle. Methodology: This randomized single-blind study was conducted on 16 doctors and 24 nurses in intensive care unit. Subjects were divided randomly into two groups, the simulation group and the discussion group. Simulation group received simulation training with HFM in conducting one-hour sepsis bundle in sepsis patients, while conventional group received case-based oral discussion with their tutor. The training was rounded off by a case simulation exam using HFM for both groups. The team performance consisted of clinical skills and communication skills evaluated through a validated assessment tool. Skills being assessed included initial assessment, diagnosing sepsis with SOFA and conducting one-hour sepsis bundle. Results: The simulation group with high fidelity manikin completed the one-hour sepsis bundle better than the conventional group (p = 0.022). Particularly in collecting venous blood samples (p = 0.027) and blood culture samples (p = 0.011), along with giving the correct intravenous fluid replacement, tailored for each scenario (p = 0.027). Communication aspect was not significantly different in both groups. Conclusion. Team performance in implementing one-hour sepsis bundle is better in the simulation group trained with high fidelity manikin as compared to conventional training group, who received case-based oral discussion.