Falls can cause broken bones, excessive bleeding, and even death. The Centers for Disease Control and Prevention reports one out of five falls can cause serious injuries which can make it hard for a person to do everyday activities or live on their own. In 2021, falls became a sentinel event, also known as a patient safety issue which results in death, permanent harm, or severe temporary harm. In caring for our nation’s Veterans, one fall is too many.
The Cincinnati VA Medical Center (CVAMC) completed a review of all facility falls in 2021 which revealed 173 incidents and an opportunity for innovative staff training. Safe Patient Handling and Mobility (SPHM) Facility Coordinator Janette Perry and Simulation Program Manager Morgan Graff began collaborating on ways to engage staff and present fall prevention concepts. A nonlinear escape room format was selected as a training modality. Gamification strategies such as escape rooms have been found to stimulate critical thinking skills, promote team collaboration, and bring excitement to learning.
Visit SimLEARN’s website to read more about how the escape room simulation presented patient safety concepts in a new format by bringing attention to fall hazards, promoting staff engagement, and fostering teambuilding through gamification.
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Simulation Training Aims to Prevent Blood Loss Deaths
 Left image: Pressure being applied to the Biofeedback Limb Trainer.
Right image: CAT Tourniquet secured to a training limb. Photography provided by Jonathan Karlen.
A person who is suffering from severe blood loss can bleed to death in as little as five minutes. Being able to keep blood inside of an injured person’s body until they can receive medical treatment is crucial to helping them stay alive. That is the goal of Stop the Bleed, a national campaign to raise awareness on how to recognize life-threatening bleeding and the interventions to save a life.
The William S. Middleton Memorial VA Hospital (VA Madison Health Care) collaborated with the University of Wisconsin-Madison Hospital and Clinics on their Stop the Bleed journey in 2020. Stop the Bleed training expanded to all community-based outpatient clinics (CBOCs) and inpatient areas, as well as recruitment of unit champions to become instructors. To date, VA Madison Health Care facility has trained 450 learners.
Discover how the training better prepared staff with the appropriate knowledge and equipment to respond to bleeding throughout VA facilities.
 Have you ever wondered what Veterans with dementia experience? How the changes of the disease affect their ability to carry out simple tasks each day? People with dementia suffer from memory disorders, personality changes, and impaired reasoning but without having dementia, it is incredibly hard to understand what a person with it is going through.
The Dementia Experience, offered at SimLEARN’s National Simulation Center and other approved locations, provides that exact insight to VA employees by offering them an immersive experience where they can walk in the shoes of a person with dementia to gain a greater understanding of daily life with the disease.
Visit VA News to learn how the Dementia Experience leads to better understanding and care of Veterans living with dementia.
Left side - pictured - Travis Garrett, Disaster Emergency Manager, Dr. Janet Sprehe, Program Director James A. Haley VA Hospital Advanced Simulation Center, Dr. Betty Holte, Clinical Nurse Educator and Melissa Baler. Right side – pictured - Dr. Betty Holte training young students who are pursuing careers in the military. Photographs provided by Janet Sprehe
The James A. Haley VA Hospital took disaster training to new levels by supporting the Tampa Bay Air Show 2022 on MacDill Air Force Base this year. Simulation resources were front and center with the hospital’s mobile simulation bus, known as the Sim Bus, and VA staff who trained more than 500 people at the Stop the Bleed event.
People of all ages were excited to learn the procedure which was initiated by the American College of Surgeons and the Hartford Consensus. The Hartford Consensus recommends that all citizens learn to stop bleeding whether it be from an active shooter or a mass casualty. The only thing more tragic than a death from bleeding is a death that could have been prevented. At the Tampa Bay Air Show 2022, Betty Holte, Janet Sprehe, and Lisa Baker, staff nurses from the James A. Haley VA Hospital, trained the public on three bleeding control actions designed to prevent death from a major bleeding event.
One of the benefits of having the Sim Bus at the Tampa Bay Air Show was it informed the community of the bus’s dual-use vehicle capabilities.
Visit SimLEARN’s website to read more about James A. Haley VA Hospital’s Sim Bus and Stop the Bleed program.
A Winner’s Perspective
By Linda G. Taylor, DNP, RN, NPD-BC, CHSE, Nurse Educator at VA Palo Alto Health Care System
In fall 2021, I saw an advertisement for the SimWars competition that was being sponsored by the Association for Nursing Professional Development (ANPD). The contest required each participant to conduct simulation debriefings. The contestant with the most effective debriefing would be the winner. At the time it sounded like fun, so I applied and was a little surprised that I was accepted.
The first round of the competition consisted of watching a virtual simulation and then facilitating a live debriefing using a virtual platform. It was intimidating, but my goal was to maintain a safe learning environment. Being it was a competition, there was no feedback provided, so I hoped that I had done enough. As you may imagine, I was thrilled when I found out that I was a finalist and would be competing in person during the ANPD convention in the Spring of 2022.
There were five finalists at the live event. We each viewed the same simulation and had 20 minutes to debrief before a live audience. I was honored to win both the first prize from the judges, and the “People’s Choice” award which was chosen by the audience.
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 Left side - Pictured left to right: Leandrea Hampton, Jimmie Gulley, Melissa Rath, Elaine Blank, and patient played by Cathie Hintz. Photography by Jean Borck. Right side - Pictured left to right: Tamenia Harris, Linda Brennan, Missy Kling as the patient, Linda Go, Lakia Lee, and LaSchel Parker. Photography by Jean Borck.
Nursing staff have reported struggles in moving patients to provide Veteran care as quickly and efficiently as possible. Staff do not realize the value safe patient handling equipment can have to prevent injury to Veterans and staff. Some staff have allowed themselves to drift in the practice of utilizing safe patient handling (SPH) equipment. Practice drifts impact Veterans and staff members. An employee may have an immediate injury or one over time, causing missed work, creating staffing issues, and negatively impacting their professional career. The safe patient handling and mobility (SPHM) coordinator wanted to address this practice drift.
With seventeen staff injuries in Fiscal Year 2021, nine of these injuries were staff attempting to catch a falling patient, and 16 out of 17 injuries involved manual handling of the patient. After determining the learning gap based on employee injuries, the decision was made to incorporate situations the learner may encounter in the clinical environment where SPH equipment would be necessary. With the new VA Mobility Screening and Solutions Tool (VA-MSST), it was decided to have a SPH escape room this year for the annual unit prevention leader training. The escape room was a collaborative effort with the simulation program. An escape room was created to allow staff to utilize the VA-MSST tool and the Post Fall Decision Tree algorithm.
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