Holy Smoke: There's a Fire in the Operating Room
Title: Holy Smoke: There's a Fire in the Operating Room
- Integrate a realistic case scenario into simulation training to maximize the learning experience.
- Discover a unique approach to address knowledge deficits regarding interventions during an operating room fire.
- Demonstrate proper management and crisis resource management skills
Recently, the Association of Perioperative Nurses (AORN) and The Joint Commission (TJC) have stressed the importance of Operating Room (OR) fire safety. One of the many competencies Labor and Delivery (L&D) staff must possess include OR specific competencies. AORN stresses the importance of education and mock drills. A needs assessment of staff, led the perinatal simulation facilitators to develop a scenario and drill that would allow all members of the Perioperative team to experience an OR fire and the steps necessary to maintain a safe environment for patient and staff alike.
Proposed change:
For the past 6 years our facility has utilized simulation-based learning focusing on high risk obstetrical events; however much of the education regarding fire safety was presented in a didactic format with little hands-on focus. Thus the perinatal simulation team developed an OR fire simulation scenario to focus on immediate intervention, role assignment, effective communication, use of the fire extinguisher and evacuation.
Implementation, outcomes and evaluation:
Since OR fires in L&D are rare, staff are not comfortable performing all the necessary steps that are needed to extinguish a fire, ensure patient and staff safety, and evacuate the OR. In L&D, the mother-infant dyad creates a unique situation and special consideration must be taken if you have a compromised infant that is requiring resuscitation. The simulation team developed an intense OR fire scenario, implemented and recorded it, and debriefed the participants immediately following. Focus was placed on the duties of the perioperative team; effective communication between the perioperative and NICU teams; extinguishing the fire with a live fire extinguisher; evacuation of the patients; and vulnerability of infant abductions during fires. Both the perioperative and NICU teams admitted to having little awareness that an OR fire could occur; the steps that must be taken during a fire to ensure safety to all and use of the fire extinguisher. The teams also voiced how the training increased not only their awareness, but gave them a better understanding of all steps that must be taken to ensure patient safety for the mother-infant dyad.
Implications for nursing practice:
By creating an innovative scenario and a unique learning experience, the simulation team was able to increase the perioperative and neonatal teams’ confidence level surrounding a circumstance that while very possible is also very rare in our environment.
Keywords:
Simulation
OR Fire
Safety
Education
Drills