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Managing medical emergencies in mental health settings using an interprofessional in-situ simulation training programme: a mixed methods evaluation study

Research output: Contribution to journalArticlepeer-review

Mary Lavelle, Chris Attoe, Christina Tritschler, Sean Cross

Original languageEnglish
Pages (from-to)103-109
JournalNurse Education Today
Early online date21 Sep 2017
Accepted/In press11 Sep 2017
E-pub ahead of print21 Sep 2017


King's Authors


Background In the UK, people with severe mental illness die up to 20 years earlier than the general population, prompting increased focus on physical health in mental illness. However, training for mental health inpatient staff to meet patients' physical health needs has not received the same attention, with physical health training often being reactive and lacking evidence of effectiveness. Objectives To evaluate an interprofessional, in situ, simulation training intervention for managing medical deterioration in mental health settings. Investigating the impact of training on: 1. Participants' knowledge, confidence, and attitudes towards managing medical deterioration; and 2. Incident reporting, as an objective index of incident management. Participants' perceptions of the impact on their practice were qualitatively explored. Design This evaluation employed a mixed-methods pre-post intervention design. Participants & Settings Fifty-three healthcare professionals participated including: mental health nurses, psychiatrists, healthcare assistants, and activity co-ordinators from two busy psychiatric triage wards in South London, UK. Methods The intervention comprised eight half-day sessions delivered weekly across two wards. Structured surveys assessed participants' knowledge, confidence, and attitudes towards medical deterioration pre and post training. Participants' experience of training was qualitatively captured through post-course surveys and focus groups three months post training. Incident reporting rates for seven-month periods pre and post training were compared. Results Following training, participants showed significant improvement in knowledge (p < .001), confidence (p < .001), and attitudes towards (p < .02) managing medical deterioration. Incident reporting increased by 33% following training. Participants' reported improved confidence in managing medical deterioration, better understanding of effective communication, improved self-reflection and team working, and an increased sense of responsibility for patients' physical health. Conclusions Interprofessional, in situ simulation training for medical deterioration yielded promising outcomes for individuals and teams. Simulation is an under-used training modality in mental health, offering a holistic training approach with the potential to provide educational and clinical benefits while supporting workforce resilience.

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