Mannequins help medics care for patients at the end of life

Published: 14-Nov-2013

CME Medical simulators used to train palliative care staff

CME Medical is helping healthcare professionals gain confidence in caring for patients at the end of their lives, providing highly-sophisticated mannequins that can talk and simulate signs and symptoms of advanced illness.

The models are being used in a pioneering and unique training programme in Birmingham.

The Hollier Simulation Centre, based at Good Hope Hospital, uses the high-fidelity mannequins, along with actors and trained staff, to simulate end-of-life situations in order to help train doctors, nurses and care workers from hospices.

Dr Lisa Boulstridge, consultant in palliative medicine at Heart of England NHS Trust, which runs the courses, said: “As far as we are aware, we are the only simulation centre in the UK which has developed such a range of training courses in end of life and palliative care.”

The courses include the use of CME Medical’s T34 Ambulatory Syringe Pump, which is commonly used during palliative care in patients’ homes, care homes, hospices and hospitals across the country.

Dr Boulstridge said: “The use of syringe drivers is an important aspect of palliative care as it enables medication to be given continuously via the subcutaneous route to maintain a patient’s symptom control. Patients approaching the end of their lives are usually unable to take medications by mouth and this delivery system enables a combination of medications to be given.”

Simulation training enables clinicians to develop their skills in a safe clinical environment which is appropriate to their usual place of work

On the importance of the mannequins, she added: “Within the simulated training scenarios the T34 is set up and attached to the patient mannequin as it would be in real life. In one of the scenarios we deliberately detach the pump from the patient to simulate it having been pulled out by a patient who is agitated. Within the scenario we are hoping that the participating clinician will consider the possibility of the pump being displaced as a reason for the patient’s symptoms becoming more severe and makes appropriate checks of the T34.

“The pump can be used for patients in any setting. It is important that all doctors and nurses who look after patients at the end of life are aware of how a syringe driver works and the potential problems which can occur. The T34 Ambulatory Syringe Pump is the syringe driver which is now used for palliative care patients within our hospital and our local hospice. It is also increasingly being used by district nurses within the community setting as it offers more safety features than the one which was previously used.”

The T34 will be used to demonstrate patient management techniques, alongside I-STAN – the high-fidelity mannequin, which is able to talk thanks to role play provided via a microphone by a member of the simulation centre team. He can also simulate a number of signs and symptoms which typically occur in palliative care patients including: pain, agitation, nausea and vomiting, fits, upper respiratory secretions, abnormal chest sounds, bleeding from tumours, alterations in pulse, blood pressure or temperature and respiratory rate.

Dr Boulstridge said: “Simulation training enables clinicians to develop their skills in a safe clinical environment which is appropriate to their usual place of work. The scenarios are versatile and can be adapted in real time to the skill level of the individual so they can be challenged but not overwhelmed by the experience."


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