High-fidelity Simulation with Debriefing: Best Practice Education for Flight Nurses?

Flight nursing is a unique subspecialty of nursing requiring an unpredictable work schedule, uncontrolled environment, limited supplies and workspace, advanced high acuity procedures, and alternative assessment and treatment approaches, and cannot be appropriately likened to any hospital-based critical care area. Due to many factors, there is an increased use of air medical helicopters, including rural hospital closures and a lack of ground emergency medical personnel. Due to this oversaturation, flight nurses may not get enough flights, or may transfer more non-critical patients. This makes it difficult for flight nurses to maintain proficiency for critical, high-acuity skills, such as intubation, required of the job. High-fidelity simulation with debriefing has been shown effective in maintaining high-risk, low volume proficiencies in nursing. The purpose of this evidence- based practice improvement project was to implement high-fidelity simulation with debriefing to measure improvements in skill acuity of providers and retention when performing intubations. The Evidence-based Practice Improvement Model by Dr. Levin was used as a framework for the development, planning, and implementation of this project. This project’s aim is to reduce flight nursing skill fade and help maintain high acuity skills. The primary outcome measures in this project were whether high-fidelity simulation and a debriefing session improves intubation time to skill completion, successful intubation, and retention. After a single high-fidelity simulation session with debriefing, participants showed clinically significant improvement in time to intubation completion and statistically significant improvement in an intubation checklist score.

A publication of this project can be found in Air Medical Journal.