Celebrating Healthcare Simulation Week

#HcSimWeek19

This week nearly everyone involved in clinical simulation education will be taking time to recognize the pioneers and to celebrate ongoing advances to help suspend disbelief in Healthcare Simulation.

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Why?

Because it’s Healthcare Simulation Week 2019!

Simulation education is dedicated to improving the quality of worldwide healthcare by using high quality healthcare simulation as a substitute for part of the traditional clinical training experience which is unpredictable and has becoming less available.

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Adding humans into clinical simulation scenarios is not a new thing, but it is OUR thing.

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We celebrate the advance of wearable simulation training products. Our ReaLifeSim products are designed to be worn by SP’s or standardized patients (volunteers or actors) offering more ways for students to safely practice their hands-on and communication skills.

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This is a good time to send a special shout out to the pioneer of standardized patients - Howard S. Barrows, M.D..

Dr. Barrows, a neurologist and medical educator created the first standardized patient in 1963 for his third-year neurology clerkship while teaching at the University of Southern California.

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ReaLifeSim wearable clinical training tools are designed by clinicians to train the way we treat.

Worn by real people to encourage provider-patient and team communication, they can also be used as an "add-on" to manikins for enhanced function and extended sustainability.

ReaLifeSim products provide smarter, more efficient experiences for students to safely "train the way you treat."

Emergency Preparedness 2.0

In a previous post on preparedness, I addressed the importance of gathering the various types of personal and community information you might need to help you, your family and neighbors in the event of an individual or community emergency situation.

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Now, I want to look at the types of equipment and supplies you may want to have on hand in case you are faced with an emergency that denies you the use of the many conveniences of daily living we’ve come to expect and often take for granted.

Regardless of the type of storm or other weather event, loss of power is often an early and frequent casualty. And its return can take anywhere from a few hours to a few weeks.

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Okay, quick survey: How many of you, when dealing with a power outage (for any reason), instinctively flip on the light switch when entering another room in your house or apartment?

You can’t see it, but both my hands are raised. The second hand is because I was carrying a flashlight at the time!

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Whether you own or rent a house, a portable generator can provide some helpful comforts until power is restored. It can really save your bacon (and the other perishables in your refrigerator) as well as power a fan or portable heater, light, radio or perhaps more importantly, the coffee maker.

If you do not have a generator available, make sure you have a supply of extra batteries and remember to charge up cell phones and power storage devices. You may also want to buy a long power cord in case your neighbor is willing to share generator power.

Food choices should be nutritious, filling and require little or no cooking. They should also be light and easy to pack in case you need to go to a public shelter until power is restored.

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When you’re getting extra water, you may want to get a few gallon jugs for minor cleaning up in the sink and fill your tub(s) with water before the storm arrives. You can use this water for flushing toilets (If you are without power, the electric pump that refills your toilet tank will not operate).

Regardless of where you are, take time to assess your specific weather-related emergency risks and prepare.

Your individual circumstances will dictate what you need to do, but the important thing is, do it, NOW.

A Pictorial Remembrance 9/11

September 11, 2001.

It’s hard to believe 18 years have passed since that fateful day.

All of us who were old enough to recognize the impact of that day, remember.

Today we share a pictorial remembrance with photo credit to AP, CBSNews, Flicker.

We remember exactly where we were when we heard the news and watched the replays as the second aircraft flew into the South Tower of the World Trade Center .

We remember exactly where we were when we heard the news and watched the replays as the second aircraft flew into the South Tower of the World Trade Center .

We remember watching as the smoke billowed from the Pentagon.

We remember watching as the smoke billowed from the Pentagon.

We remember the incredible sacrifice of the heroic passengers who took Flight 93 down rather than allow it to reach its intended target in Washington, DC.

We remember the incredible sacrifice of the heroic passengers who took Flight 93 down rather than allow it to reach its intended target in Washington, DC.

We remember the hundreds of selfless first responders who lost their lives and countless more that risked their own health and safety to find and save our fellow citizens.

We remember the hundreds of selfless first responders who lost their lives and countless more that risked their own health and safety to find and save our fellow citizens.

We remember the thousands of victims and the thousands more family, friends, neighbors and co-workers who suddenly and tragically experienced significant losses in their lives.

We remember the thousands of victims and the thousands more family, friends, neighbors and co-workers who suddenly and tragically experienced significant losses in their lives.

We need to remember, too, all those still suffering from life-altering physical and mental injuries and illnesses to this day.

We need to remember, too, all those still suffering from life-altering physical and mental injuries and illnesses to this day.

We need to remember, if you see something – say something.

We need to remember, if you see something – say something.

We need to remember how we were galvanized as a nation that day and celebrated our shared gifts of freedom and unity – gifts we still share today. 9/11 is a day for remembrance.

We need to remember how we were galvanized as a nation that day and celebrated our shared gifts of freedom and unity – gifts we still share today. 9/11 is a day for remembrance.

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Help First Responders - National Suicide Prevention Month

From police officers to firefighters, studies show that suicide continues to outpace other causes of death for first responders.

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Today’s blog I focus on these ordinary people called upon every day to do extraordinary things!

We all go into healthcare with a dedication and commitment to help. We take loans for school, we miss our children’s school and recreational events, major and everyday family events and milestones – all to be our best for others.

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With such high stakes - we certainly want to do our best for the people that need our care – whether it’s life-saving actions, bringing in a new life, or helping an old life to feel comfort at the end.

We need to help each other. Be a friend. Stay connected. Ask the questions. Look for help - together.

A white paper commissioned by the Foundation has revealed that first responders (policemen and firefighters) are more likely to die by suicide than in the line of duty. In 2017, there were at least 103 firefighter suicides and 140 police officer suicides. In contrast, 93 firefighters and 129 police officers died in the line of duty. Suicide is a result of mental illness, including depression and PTSD, which stems from constant exposure to death and destruction.
— Ruderman White Paper on Mental Health and Suicide of First Responders
photo: DOUG KANTER/AFP/GETTY

photo: DOUG KANTER/AFP/GETTY

The Ruderman White Paper on Mental Health and Suicide of First Responders, examined a number of factors contributing to mental health issues among first responders and what leads to their elevated rate of suicide. First responders on a call and do not arrive on scene thinking “Maybe I won’t go this time because I might have health or stress issues later.” In just one example 412 emergency workers died responding to the attacks on the World Trade Centers in NYC on September 11th.

Public safety is a difficult profession that can lead to mental health struggles – and those struggles cannot be left untreated. More police officers died by suicide than in the line of duty in 2018, as was the case the previous year and the year prior to that. A study commissioned by the Ruderman Family Foundation found that firefighters are also more likely to die by suicide than in the line of duty.
— PoliceOne.com Jan 2019
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The Code Green Campaign®

In March of 2014 one of our founders experienced the suicide death of a co-worker. In the days after she realized many of the first responders she knew had also lost friends and co-workers to suicide. A small group began discussing the stigma first responders face and what they could do about it. Code Green’s founders agreed that if there is one thing that first responders like to do it is tell stories. They felt that if first responders had an outlet to tell their stories anonymously that might reduce the stigma. This storytelling project evolved into The Code Green Campaign®.

The Code Green Campaign® is a first responder oriented mental health advocacy and education organization. Also known as Code Green, we serve all types of first responders. This includes firefighters, EMTs, paramedics, dispatchers, police, corrections, air medical, and search & rescue. Our name is a combination of the color for mental health awareness (green) and the “code alerts” used in emergency services. If someone is having a stroke or heart attack first responders will call a “code stroke” or “code STEMI”. The idea is that Code Green is calling a code alert on the mental health of first responders.

Additional resources include:

Safe Call Now – 1-206-459-3020
A 24/7 help line staffed by first responders for first responders and their family members. They can assist with treatment options for responders who are suffering from mental health, substance abuse and other personal issues.

Fire/EMS Helpline – 1-888-731-3473

Also known as Share The Load. A program run by the National Volunteer Fire Council. They have a help line, text based help service, and have also collected a list of many good resources for people looking for help and support.

Copline (Law Enforcement Only) – 1-800-267-5463

A confidential helpline for members of US law enforcement. Their website also has additional information on help and resources.

Frontline Helpline – 1-866-676-7500

Run by Frontline Responder Services. Offer 24/7 coverage with first responder call-takers.

Please like and share and check back for more information related to suicide prevention for Veterans.

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September is National Preparedness Month

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The summer is gone with a blink of the eye and now it’s September, already - “Emergency Preparedness Month.” Being prepared is really a year-round activity and when I say “prepare,” I mean in advance, before the emergency arrives.

While different types of emergency situations may require different types of preparation, there is one step that should take precedence – information gathering.

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The first type of information is personal and would include the identification of yourself and every member of your immediate family including full name, age, birthdate, home address, phone number(s), email address(es), relationship and work address for starters. This list should also include family members who live away from you whether across town or across the country. And, when it comes to you and your family, a list of basic health information, including chronic medical conditions, mobility challenges, medications and allergies can be life-saving.

You can make a hard copy for storage in your personal record file or keep it on a thumb drive or other digital media including your smartphone.

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Visit federal, state and local emergency management, suicide and crisis websites for information on local resources and hotlines. Identify the location and non-emergency phone numbers for the closest police station, fire department, as well as the nearest shelter or Red Cross facility.

Having this information gathered, organized and readily available can make a big difference in managing most any type of emergency situation you might face.

Give yourself the peace of mind that comes from having taken this important step in preparation.

We’ll have other preparation tips and resources throughout the month, so please like and share and check back soon.

Businesses Need to Prepare for Natural Disasters - the Time is Now

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Shared from Ashley D. Bell, Region IV Administrator, U.S. Small Business Administration 
Covering: Alabama, Florida, Georgia, Mississippi, Kentucky, North Carolina, South Carolina, Tennessee

September is National Preparedness Month. I view this as not a celebration, but as a critical reminder for entrepreneurs across the Southeast of how important it is to be prepared in case of any natural disaster, whether it is a hurricane, tornado, wild fire, algae bloom – the list goes on. In order for a small business to survive a natural disaster, it must be prepared.

Here are a few tips for entrepreneurs to keep in mind, especially as we reach the peak of hurricane season across the Southeast:

  • Review your hazard and flood coverage to ensure your insurance policy is in effect before a storm hits.

  • Keep your insurance policy information as well as phone numbers for your insurance agent and the claims department handy.

  • Know whom you can call to help you clean/rebuild your business, and have a restoration plan in place so you can focus on the task of quickly reopening your business.

  • Maintain an updated list of all your employees’ contact numbers and email addresses to ensure safety, as well as keeping everyone in the loop about the recovery progress.

  • Obtain a line of credit or have enough cash to run your business for at least three months.

  • Move your important business records, personal memorabilia and anything that’s irreplaceable to an offsite location. Save as much as you possibly can to the cloud.

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Currently, there are 11 disasters declared by the President or the SBA across the Southeast Region that are eligible for loan assistance. These declared disasters range from Hurricane Michael to gas leaks and flooding incidents. A complete listing of open disaster declarations may be found here with pertinent information such as disaster assistance deadlines.

Please keep in mind that the SBA provides low-interest loans and assistance to allow affected businesses, homeowners and renters to rebuild and recover.

Specifically, the SBA:

  • Provides loan assistance up to $200,000 to help homeowners repair or replace their damaged or destroyed primary residence.

  • Provides up to $40,000 in loan assistance to help homeowners and renters replace damaged or destroyed personal property such as furniture, clothing, appliances and vehicles.

  • Provides up to $2 million to repair or replace damaged real estate, leasehold improvements, furniture and fixtures, inventory, and machinery and equipment for businesses of all sizes and private non-profit organizations.

  • Offers Economic Injury Disaster Loans (EIDL) to small businesses, small agricultural cooperatives, and most private non-profit organizations that have suffered economic injury caused by a disaster. These loans provide working capital to a business or organization until normal operations can resume.

Please stay prepared, and you are always welcome to reach out to the SBA for assistance at www.sba.gov/disaster. Our job is to help you build a lasting business for many generations, no matter what nature has in store for us.

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Confident Voices in Healthcare - online resources for interpersonal communication

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Studies continue to show technical and communication errors are at the root of most of the morbidity and mortality statistics reported each year.

The Confident Voices in Healthcare resource provides a free online library for the healthcare workforce designed to promote emotional intelligence (EQ) and interpersonal skills. There are e-books, podcasts, and more.

We’ve been struggling with communication problems and medical errors since the turn of the century. Why? Because communication is WAY more complicated than we realize and the related ‘soft’ skills are hard to develop and practice. Especially in the high-stakes, high-stress work of healthcare.
— Beth Boynton, RN, MS, Author and Medical Improv Pioneer

Medical Improv is a primary focus among their resources. It’s a train the trainer series designed to help healthcare leaders build 'soft' skills in their teams and organizations. These ‘soft’ skills impact patient safety, patient experience, cost-effectiveness, workforce health and well-being, and workplace culture.

Good clinical simulation is an excellent option and helps students suspend disbelief when practicing skills. For some it may be hard to provide the interpersonal communication practice they’d like primarily using manikins in clinical simulation.

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ReaLifeSim’s wearable IV training simulators provide students the opportunity to safely practice their hands-on skills to a level of competence, while simultaneously relating to the “patient” as a real person in a way that communicates confidence and inspires trust from the patient. The improved communication skills benefit and improve clinical team communication.

ReaLifeSim has been recognized as one of the top global patient safety advocates.

Do No Harm – It's More Than a Promise

While the phrase, “First, do no harm,” does not appear, as such, in the Hippocratic Oath, it is widely accepted as one of the significant principles under which physicians, and, by extension, others in the healthcare field operate in the practice of medicine.

With few exceptions, those who pursue careers in healthcare, do so from a sincere desire to help others in achieving, maintaining and recovering an appropriate level of physical and mental health. While some clinical interventions can be temporarily painful or unpleasant, there is no intent by the care provider to inflict pain or discomfort on a patient.

FIRST DO NO HARM, by BENJAMIN SCHWARTZ ,  New Yorker Cartoons

FIRST DO NO HARM, by BENJAMIN SCHWARTZ, New Yorker Cartoons

For some of the more routine clinical activities, it takes more than a lack of intent to keep from inflicting unnecessary pain, it takes practice, practice and more practice. And, not just any practice - it takes realistic practice.

For example, take the skill of drawing blood or starting an IV. These are a fairly straight forward activities requiring the clinician to safely insert a needle into the vein of a patient. It is a task covered early in clinical training, but is it practiced as often or as realistically as we believe? Many of us have experienced the real pain and discomfort some providers unintentionally cause when drawing blood or starting an IV.

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Now, some might say it’s “just” a bruise, but in fact, a bruise is an injury producing an area of discolored skin due to the rupturing of the underlying blood vessels. For many it may be “just” uncomfortable and unsightly, but depending on the patient and other medical variables, it may pose a real danger or at least complicate other elements of the patient’s health.

To make good on their commitment to “Do No Harm,” clinical learners and practitioners alike must attain and maintain their hands-on skills to ensure they do not hurt the patient in the process of delivering the care they need.

It was for that very reason ReaLifeSim products were created. ReaLifeSim’s wearable IV training simulator permits students to conduct safe, repeated, realistic practice on a live people (SP’s, volunteers, or each other) to build both the competence and confidence necessary to “do no harm.”

Photo credit: ENA2018

Photo credit: ENA2018