Interprofessional veno-veno bypass simulation improved team confidence

Background: Rarely performed procedures can cause stress and communication challenges in emergency situations. A simulation was developed to practice and improve team performance and procedural workflow when it has been determined that a liver transplant patient will need veno-veno bypass. The scenario involved a patient predetermined to need veno-veno bypass to allow team members to practice procedural workflow and communication. The simulation used a checklist outlining steps of the procedure and expected communication needed among surgeon, anesthesiologist, nurses, and perfusion team members. Perfusion and nursing supplied equipment to simulate the veno-veno bypass. Debriefing and a brief survey followed the simulation.

Results: During the simulation participants performed steps outlined in the checklist. During debriefing, discussion occurred regarding equipment usage, step order, time documentation, and medication use. Additional discussions occurred regarding modifying perfusion tubing and supplies. Participants rated their confidence in understanding communication (4.2), ability to work with others (4.6), knowledge of supplies (4.4), and use of closed-loop communication (4.4) on a scale of 1 (not at all confident) to 5 (extremely confident) (n = 5).

Conclusion: Participants concluded going through veno-veno bypass steps was a positive experience. Surgeons acknowledged there were multiple ways to perform this procedure and agreed it should be done the same way each time for standardization. Nursing staff commented they liked reviewing equipment in a nonemergency situation. The checklist will be turned into a resource for future operating room procedures. The perfusion team made modifications to their equipment based on surgeon recommendations. Future training is planned when new members join the team.