Northern California Health Care System simulation and COVID ready
By Vanessa Aycock, RN, MSN, CCRN-K, BC, CEN
Simulation Nurse Educator
Northern California Health Care System
MATHER, Calif. – The Sacramento VA Medical Center (VAMC) is the parent facility for the Northern California Health Care System (NCHCS) in VISN 21. It is comprised of nine Outpatient Clinics located in the California cities of Chico, Fairfield, Mare Island, Martinez, McClellan, Oakland, Redding, Yreka and Yuba City. In addition, a rehabilitation and extended care facility is also located in Martinez.
With the outbreak of COVID 19 in February 2020, the Simulation Team at NCHCS began to collaborate and create scenarios for intubation of a COVID positive patient, donning and doffing of personal protective equipment, and transporting COVID positive patients throughout the medical center. In addition, the team addressed the swabbing of patients, use of the hepafilter on a bag valve mask device along with the new algorithms for Basic Life Support and Advanced Life Support as published by the American Heart Association, mock codes of a COVID positive patient, and post mortem care.
NCHCS serves an area consisting of more than 375,000 Veterans dispersed over a wide geographical area spanning 40,000 square miles and employees over 4,000 employees. The medical center is comprised of four operating rooms, a cardiac catheterization and an angiography suite, as well as a sleep study lab, gastrointestinal endoscopy suites, 29 medical-surgical beds, 29 telemetry care unit beds, 10 intensive care unit beds, 16 behavioral health inpatient beds, and 120 bed Community Living Center.
The team practiced social distancing and the constant use of face masks during the simulation training, which was conducted in the simulation laboratory, as well as in situ. To date over 500 staff members have been trained.
One technique that was utilized included use of a skills competency program in order to capture close to 100% of nursing staff for the topics of COVID. It included the low volume, high risk topics such as use of restraints, code sepsis, moderate sedation, rapid sequence intubation, cardiac medications, stroke management and other topics. The evaluations collected from the participants were overwhelmingly positive, and many staff indicated they enjoyed the simulations, and that the training made the situations more life like.
The simulation team consists of nurse educators from the intensive care unit and emergency department, operating room, primary care, gastroenterology, medical/telemetry, the Resuscitation Education Initiative (REdI) program director, who is a nurse, a simulation nurse educator, and an anesthesiologist who is the medical director for simulation.
The Simulation Team uses simulation to conduct the Trauma Nursing Core Course (TNCC) in collaboration with the VHA SimLEARN National Simulation Center, in Orlando, Florida. The course is offered four times each year to nurses in the emergency department, telemetry and the intensive care unit, as well as to the Intermediate Care Technicians (ICT).
The NCHCS Simulation Team also recently collaborated with the Palo Alto VA Medical Center in Palo Alto, California, and they will be sending nurses and ICT’s to attend this training. Upon completion the nurses and the ICT’s are awarded 18.2 continuing education credits through the Emergency Nurses Association.
The VHA public internet site for COVID-19 training is www.va.gov/COVIDtraining.