Kiran Sharma

Dr Sharma is a Psychiatry Registrar at Townsville University Hospital. She has graduated from the University of Toronto with a Bachelor of Medical Radiation Science degree and a Medical degree from James Cook University. She holds an interest in both physical and mental health. She is passionate about improving health outcomes for mental health consumers and undertook this project as a quality improvement initiative and Royal Australian and New Zealand College of Psychiatrists (RANZCP) scholarly project. When not working, she enjoys spending time with her loving children and husband.

Title: Medical emergency simulation training for doctors and nurses in psychiatry

Author(s): Dr Kiran Sharma, Supervisors: Professor Brett McDermott, Dr Pallavi Dham

Introduction: Patients with severe mental illness die 10-25 years earlier and have double the mortality rate as the general population in the year following their discharge from hospital. Mental health consumers remain marginalised with poorer physical health despite advances in medicine. Whilst individual, illness and treatment factors have a large impact on these statistics, the contribution from healthcare professionals and organisations cannot be ignored. Australian hospitals, rely on Medical Emergency Teams for rapid response. When there is a delay, the responsibility to stabilise the inpatient relies on psychiatry doctors and nurses. With infrequent medical emergencies in psychiatric facilities, doctors and nurses may not feel confident or prepared to respond. Regular simulation training may bolster confidence and skills.

Methods: The aim of our project was to evaluate current attitudes, confidence level and knowledge in Psychiatric trainees or psychiatrists and mental health nurses in responding to medical emergencies. Then, to evaluate the change in attitudes, confidence level, and knowledge base of the target cohort following structured simulation training.

A pre and post-intervention design was used to evaluate a change of the participants using questionnaires before and after Essential Life Support (ELS) Simulation Training. Paired T tests were used to analyse change in attitudes, confidence in self and the team and knowledge.

Results and Findings: In thirty-five participants, we found that attitudes (p 0.049) and confidence level (p 0.0005) had a significant improvement with an increase in knowledge scores after intervention (p 0.09). Comments were supportive of the training.

Discussion: Many doctors and nurses in mental health feel inadequately prepared and lack confidence in themselves and their colleagues to respond to medical emergencies. A structured simulation course was significantly useful in shifting attitudes, building confidence and developing knowledge and skills to benefit the team and patients when medical emergencies arise.