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Publication Debriefing nontechnical skills in healthcare simulation: A facilitators guide(University of Galway and Irish Centre for Applied Patient Safety and Simulation (ICAPSS), 2024) O'Dea, Angela; Byrne, Dara; O'Connor, PaulIt has been suggested that facilitators often find it challenging to observe and debrief nontechnical skills [1]. Nontechnical skills are the cognitive, personal resource, and social skills that complement a healthcare worker’s technical ability, and are crucial to safe and effective team performance [2]. This guide will provide: (i) a brief overview of the nontechnical skills that are particularly important for healthcare practitioners, (ii) common issues associated with each skill that are observed during simulation training, and (iii) examples of questions facilitators can ask about these nontechnical skills during the debriefing. The nontechnical skills that will be covered in this guide include: • Situation awareness • Decision making • Communication • Teamworking • Leadership • Managing stress This guide provides a brief introduction to nontechnical skills and how to debrief them. For guidance on debriefing and healthcare simulation more broadly, we suggest reading O’Connor et al’s [3] introductory text on healthcare simulation. If you are interested in human factors more broadly, we suggest reading O’Connor & O’Dea’s [4] guide to human factors in healthcare. At the end of each section we have identified particular issues –related to each non technical skill - that may occur during a team simulation event, that facilitators can look out for. Additionally we present potential questions you might use to open a discussion on these issues during the debriefing. This is not intended to be an exhaustive list of possible issues and questions, and you may only cover one or two issues on each skill. Similarly, you are unlikely to cover every nontechnical skill during a debrief. A summary of the points to look out for during the scenario, and accompanying questions, for all of the nontechnical skills is provided in the appendix at the end of this document.Publication A compendium of the steps required to complete 13 essential procedural skills(University of Galway, 2022-09) Reid-McDermott, B.; O'Connor, Paul; Carey, C.; Cooney R.; Egan, C.; Lydon, S.; Madden, C.; McLoughlin, M.; Mongan, O.; Parackal Augusthinose, P.; Reid, A.; Smith, M.; Byrne, D.Entrustable Professional Activities (EPAs) are units of professional practice that capture essential competencies in which trainees must become proficient before undertaking them independently. EPAs provide supervisors with a solid justification for delegating an activity to trainees. A framework of seven EPAs, and associated competencies have been developed for interns in Ireland. These EPAs address all the core activities that interns should be readily entrusted with at the end of the intern year. These EPAs are: EPA 1: Clerk a patient. EPA 2: Request and interpret basic investigations. EPA 3: Perform essential procedural skills. EPA 4: Manage the work of in-patient care. EPA 5: Prescribe and monitor drugs and fluids. EPA 6: Recognise and manage the deteriorating/acutely unwell patient. EPA 7: Handover and discharge a patient. These seven EPAs, and the process used to develop them, are discussed in more detail elsewhere.1,2 The focus of this compendium is to outline the steps required to correctly complete the 13 essential procedural skills that comprise EPA 3, which are: 1. completing an electrocardiogram; 2. blood sampling and blood cultures from central lines; 3. peripheral intravenous cannulation; 4. preparation, reconstitution, dilution and administration of IV drugs; 5. arterial blood gas sampling; 6. nasogastric tube insertion; 7. urinary catheter insertion; 8. venepuncture; 9. blood cultures from a peripheral vein; 10. sterile field set up; 11. sterile glove application; 12. hand hygiene; 13. donning and doffing PPE. The steps required to perform each of these procedures were developed by subject matter experts from the Irish Centre for Applied Patient Safety and Simulation (ICAPSS). They identified these steps based upon their own clinical experience and a review of published materials on these procedures. This compendium provides a detailed outline of procedures 1 to 10 above. Setting up a sterile field is described as a step in the urinary catheter insertion procedure. Sterile glove application is described as a step in the skills of blood sampling and cultures from a central lines and urinary catheter insertion. Hand hygiene is a required step which is described in all procedures. Donning and doffing is a new addition since the Covid-19 pandemic and is described as a standalone procedure despite it being required to execute the other procedures where personal protective equipment (PPE) is part of the infection control requirements. It is important to indicate that there is often more than one correct way to complete these procedures. Our goal was to identify ‘one correct way’ to complete these procedures to support standardisation in how these procedures are both taught and assessed. It is hoped that this compendium will be useful for others teaching, and learning, how to carry out these 13 essential procedural skills.Publication Learning from complaints about hospital care(National University of Ireland Galway, 2022) O'Dowd, Emily; Lydon, Sinéad; Lambe, Kathryn; Vellinga, Akke; Rudland, Chris; Ahern, Elaine; Hilton, Aoife; Ward, Marie E.; Kane, Maria; Reader, Tom; Gillespie, Alex; Vaughan, David; Slattery, Dubhfeasa; O'Connor, PaulComplaints are often seen as a negative experience in healthcare, with patients or family members writing about poor experiences of care, or things that went wrong. These things that go wrong may be small issues or major problems. Patient complaints are usually written with the aim of helping to improve healthcare for future patients. Patients may have a perspective that differs from healthcare providers. For example, providers might not know about how patients dignity was respected, whether they experienced delays, or how they were interacted with. Patients, however, know all of these things. It is known that patient insights into their care can improve healthcare. However, these insights may not be considered to the same extent as staff measures of quality and safety of care. Most assessments of quality of care in Irish healthcare services are focused on healthcare workers’ opinions, statistics about observable events (e.g., how many patients got an infection in hospital), or investigating large errors. Until recently, complaints have not been used by hospitals or the healthcare service in Ireland to make broad improvements to healthcare delivery. While these complaints receive individual responses, there is no focus on analysing these complaints together and using this data to learn about key issues in specific services and the healthcare system. This means that patients’ desire, and ability, to contribute to identifying problems and potential solutions are limited. Researchers at the London School of Economics have developed the Healthcare Complaints Analysis Tool (HCAT)1 that guides the systematic analysis of the cause and severity of complaints. The Health Research Board (HRB) and Health Service Executive (HSE) funded research project utilised the HCAT to analyse complaints received about Irish healthcare organisations. The research involved the collaboration of researchers, HSE managerial staff, healthcare workers, and quality and patient safety professionals in hospitals.Publication Analysing complaints about primary care with the healthcare complaints analysis tool (General Practice): A user’s guide(National University of Ireland Galway, 2022-01) O’Dowd, Emily; Lydon, Sinéad; Reader, Tom; Gillespie, Alex; O’Connor, PaulGeneral practice is a vital aspect of the health service, with large numbers of patient contacts every year1. While general practice is often seen as inherently less risky than secondary care2, errors have been found to occur in between 2–3% of consultations3. A recent study in Irish out-of-hours general practice found a complaints rate of 0.61 per 1000 consultations4. Patient complaints are an under-utilised source of data about quality of care. Typically, complaints are resolved on an individual basis by responding to the person who made the complaint and addressing their concerns.It is acknowledged that receiving a complaint can be a stressful, negative experience for healthcare providers5. It may be beneficial for a healthcare provider who has received a conplaint against them to liase with an indeminfier, who will be in a position to offer help, support, amd reassurance. However, research and policy is shifting towards reframing complaints from a negative experience, to using them as a valuable source of data to support quality improvement efforts. Until recently there has been a lack of valid and reliable systems for examing trends across complaints at a regional and/or national level6, but there are now valid and reliable tools for analysing complaints about hospital and general practice care.The Healthcare Complaints Analysis Tool (HCAT) was developed to systematically analyse complaints about secondary care. Information on the HCAT is available online7. However, while the HCAT is a suitable tool for analysing hospital complaints, it cannot be directly applied to analysing complaints about general practice. This guide outlines how to use the Healthcare Complaints Analysis Tool (General Practice) [HCAT(GP)] to analyse general practice complaints. The HCAT(GP) is based upon the original HCAT, but tailored specifically for general practice. Evaluations of HCAT(GP) have found that it is a valid and reliable tool for analysing complaints about general practice.Publication An introduction to human factors for healthcare workers(Health Services Executive, 2021-11-20) O'Connor, Paul; O'Dea, AngelaThis document: (1) provides a comprehensive overview of human factors; (2) supports healthcare workers to identify the human factors issues in their workplace; (3) supports the identification of the human factors contributors to incidents; and (4) provides examples of human factors interventions that have been used in healthcare settings.Publication National strategic guide for the implementation of simulation on clinical sites(National University of Ireland Galway, 2021-06) Byrne, Dara; O'Dowd, Emily; Lydon, Sinéad; Reid McDermot, Bronwyn; O'Connor, Paul[No abstract available]Publication A toolkit for improving hand hygiene compliance in intensive care(National University of Ireland Galway, 2020-10-15) Lambe, Kathryn; Lydon, Sinéad; McSharry, Jenny; Byrne, Molly; Squires, Janet; Power, Michael; Domegan, Christine; O'Connor, Paul; Health Research BoardA toolkit to help intensive care units to identify how they can improve hand hygiene compliance.