Exercise with PNWU, Memorial helps improve health care in Yakima County | Local

A 12-day-old baby is lying on a hospital bed. His heart rate approaches 200 beats per minute while his blood oxygen levels plummet into the 60s. A team of nurses from Yakima Valley Memorial Hospital surrounds the baby. A dozen questions are asked and answered in seconds. Everyone is racing to get the baby back to a stable condition.

The baby’s father talks to a nurse who tries to reassure him as she asks about the child’s medical history. It is fickle and noisy. He gets up and paces around the room, getting in everyone’s way. He wants to help but can only answer the same question over and over “what’s up?”

This type of situation has become more common for the handful of ED, pediatric and NICU nurses in the room. Fortunately, this case was an exercise conducted in the Pacific Northwest Health Sciences University Simulation Laboratory.

Over the past 25 years or so, simulation labs have become commonplace among medical schools across the country. A combination of experienced guidance staff, state-of-the-art technology and, in some cases, actors, allowed medical and nursing students to experience near-real-life scenarios without the consequences that can come with encountering an unusual emergency for the first time .

While PNWU and Memorial have long shared a partnership as organizations focused on improving health care conditions in the area, these joint simulations, which also include PNWU students, are the first of their kind in Yakima County.

“Historically, there’s always been a desire for a partnership like this (between PNWU and Memorial),” said Lisa Steele, executive director of the PNWU Simulation Center. “About six months before COVID, this was the first time we tried to start a simulation activity with Memorial Hospital.”







Andrea Shirley, center, Adrian Araiza, right, both RNs in the NICU at Yakima Valley Memorial Hospital, and Stephanie Shamsi, a floating nurse at Memorial, examine the baby dummy before beginning a simulated exercise at Pacific Northwest University in Yakima, Washington , Wednesday, October 19, 2022



When the pandemic hit, hospitals and medical schools everywhere were overwhelmed. The moment was not right.

Talk of a joint simulation resurfaced in 2021, Steele said. By 2022, she said, Memorial staff is seeing an increase in newborn health emergencies.

“The hospital staff told us, ‘We have this situation that is occurring more often in the hospital. It’s not something we see that often and we just want to make sure we’re well equipped and well prepared to deal with it,” Steele said.

Those talks bore fruit when the first joint simulation took place last week.







PNWU Simulation Program

RNs from Yakima Valley Memorial Hospital participate in a simulated exercise at Pacific Northwest University in Yakima, Wash., Wednesday, Oct. 19, 2022.



The PNWU SIM Center consists of several rooms in the north wing of Butler-Haney Hall. The building features several replica hospital rooms complete with equipment and monitors.

Professors, SIM Center staff and other observers sit across the hall in a control room where they can monitor students via live camera from inside the hospital room. Monitoring equipment that measures blood pressure and oxygen levels is fed directly to the control room.

In hospital rooms, mannequins representing different genders and health needs are used for patients. Some of these mannequins breathe, make sounds and allow people to insert IVs, catheters and breathing tubes.







PNWU Simulation Program

Andrea Espinosa, simulation technologist, listens to a simulation from the control room at Pacific Northwest University in Yakima, Washington, Wednesday, Oct. 19, 2022.



During initial conversations with Dr. Catherine J. Koozer, a pediatrician at Memorial, Steele said there was a focus on using the SIM Center in a way that would benefit the community, not just the staff who use it.

“We started thinking about how we could partner, how we could join forces and really do something that would not only impact on an educational level, but also on a community level,” she said.

Because simulation labs are common enough that many current health care providers have used them at some point during their training, Steele said the people she spoke with at Memorial all saw the value of using simulations as a way to both stay aware of routine procedures and prepare for the unexpected.

“A lot of our providers coming in now, they’ve had those exposures (to simulations),” Steele said. “Then they walk into a hospital and see areas of potential improvement or educational opportunities and it’s like, ‘Why aren’t we doing SIM?'”

On the day of the simulation, Chelan Shepherd, assistant director of simulation quality assurance, sat down with PNWU and Memorial staff. She walked the group through their scenario with the baby and gave them a tour of the simulation room, where all the tools they needed were ready on the table next to the hospital bed.







PNWU Simulation Program

Thomas Eglin, MD and assistant professor of family medicine, orients participants from Yakima Valley Memorial Hospital before beginning a simulated exercise at Pacific Northwest University in Yakima, Wash., Wednesday, Oct. 19, 2022.



After two checks, both of which were followed by a debriefing, Shepard went around the room and asked all participants if they had learned anything new.

Although there was more than a century’s worth of experience in the room, every nurse, doctor and professor had learned something new in the 25 minutes they spent in the simulation room. Some have learned from experience themselves, others from their colleagues.

After debriefing after the second simulation, Skyler Davis, an emergency room nurse, said he learned about the relationship between a baby’s gestational age and its blood pressure. Knowing this can help providers understand what a healthy blood pressure is for a child.

As he shared this with the group, heads nodded in agreement.

Although many of the observations made by PNWU professors and Memorial staff were technical in nature, Andrea Shirley, a NICU nurse, made a comment that changed the way the seven nurses in the room would work together.

“I like the idea of ​​hearing that you’re happy to see us (NICU nurses) come to the ER,” she said. “Sometimes I feel like I’m stepping on toes. I wonder if it’s okay to do certain things.

Janice Northup, pediatrics and NICU nurse manager, agreed with Shirley. She said she enjoyed being in a collaborative environment with nurses from other departments.

While it’s not uncommon for these nurses to work together, she said putting them in a simulation like the one they had just done helped break down communication barriers and address concerns about the best way to work. in someone else’s ward.

Steele said that’s exactly what she envisions for the joint simulations conducted by PNWU and Memorial staff. With PWNU’s SIM Center set to more than double in size after the addition of an 80,000-square-foot Student Collaborative Learning Building next year, Steele said more collaborative simulations with other Yakima County health organizations are on the horizon.

“That’s really the ultimate goal. We ask what are the barriers? What are the problems, what things are not going the way we want? Where are the deficits? What are we not so well prepared for and how do we make those changes?” Steele said.

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