2023-06-23 13:08:21
On June 22, the national association for the continuing education of hospital staff (ANFH) unveiled the 16th winners of its prize, rewarding the creativity of establishments in offering their teams training courses that are as close as possible to their needs, as innovative as beneficial. Among the 5 rewarded actions, it is the GHU Paris Psychiatry and Neurosciences which wins the “Grand Prize” for its project of “Exercise of simulation of call for reinforcement in real conditions”.
The GHU is an institution with significant psychiatric activity. The issue of managing patient violence (its prevention, anticipation and actual management) is a daily issue. The GHU is very active on the subject and has created a Local Observatory of Violence (OLV) for several years now. The management of the crisis and the violence that it can generate with regard to the personnel sometimes requires the call for reinforcement between the services and in this case, cohesion, collaboration and cooperation must be at the rendezvous. To improve the latter, and therefore both patient care and quality of life at work, the GHU Paris Psychiatry & Neurosciences has relied on in situ simulation.
« The local violence observatory therefore wanted to go further by offering training in calling for reinforcements in real and in situ situations, explains Noémie Schoebel, director of human resources at the GHU. There was a dual objective behind this idea: to improve the quality of life at work for our agents and to improve patient care in crisis situations. Started in the spring of 2021, the reflection materialized six months later with the writing of four call-for-reinforcement scenarios. ” We took the time to develop them from clinical cases, calling on the skills of our professionals: the psychiatrist in charge of the OLV, a professional from our CPOA (the Psychiatric Orientation and Reception Center) and trainers from our Ifsi, to ensure that the situations are conducive to learningexplains Dunia Mutabesha-Schittulli, director of users, quality and risk management at the GHU, and designer of the training. The scenario is really crucial in health simulation, because it is what will make the teams adhere or not, and allow them to learn. It has to be very believable, but also very precise so that the actor playing the role of the patient can react in depending on the behavior of caregivers. A test session is organized from October 2021, then the training spreads to the departments.
The scenario was as follows: a patient in a so-called “manic” state refuses to return to her room; staff must bring it to de-escalation.
Being faced with a situation that might happen to us in an hour, a day or a week
« We had to think as a team regarding how to manage the situation, explains Maïté Berruyer, psychiatric nurse at GHU Paris. This allowed us to start thinking regarding improving our care in these cases. » Diogo Nogueira, cadre du service, abonde : « This exercise allows us not to make injunctions, but to decide collectively on the best thing to do. » Beyond learning purely technical gestures, on the proper safety of a patient for example, the simulation exercise aims above all to make the agents progress on more diffuse skills: communication, cooperation, cohesion… which are learned more effectively during real-life situations than through theory. During the training, which takes place over three hours, part of the service is an actress, while the other is an observer. The program includes a briefing, which outlines the assessment of the violence at the level of the GHU Paris, then the simulation itself, and finally the debriefing, using images filmed during the simulation. The agents appreciate the fact that the management takes concrete charge of the question of the management of the physical crisis and approves the simulation method. In general, they ask that their colleagues be able to benefit from it quickly, believing themselves to benefit from it. A practical guide
intended for professionals was developed in parallel with the training.
« In a crisis situation, there can be no room for splitting or ambiguity, summarizes Diogo Nogueira, health executive. Thanks to this training, our teams have improved their method and their organization. They have gained in serenity as well as in safety. »
The simulation training set up by the GHU Paris also has the particularity of taking place in situ, which, once more, offers a double advantage. On the one hand, it allows agents to come back to training: they do not have to travel, the exercise comes to them, so time management is less of an obstacle. On the other hand, in situations of violence, the configuration of the premises plays an important role: the teams do not move in the same way and do not secure the patient in the same way in all the departments… which training in the unit itself allows to take into account.
« If simulation in health is thus already frequently used for emergency gestures for example, this first implementation by the GHU Paris proves that it also has its place in psychiatry.«
See the video of the project of the University Hospital Group Paris psychiatry & neurosciences
• The ANFH unveils the 16th winners of the ANFH Prize, press release of June 22, 2023.
• See all the Prizes, in detail, on the ANFH Prize Booklet (PDF)
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