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Off-ward paediatric in situ simulation: are we ready?
  1. Caroline Hart,
  2. Ben McNaughten,
  3. Andrew Thompson,
  4. Thomas Bourke
  1. Royal Belfast Hospital for Sick Children, Belfast, UK
  1. Correspondence to Dr Ben McNaughten, Royal Belfast Hospital for Sick Children, 180-184 Falls Road, Belfast, UK; benjamin.mcnaughten{at}

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In our tertiary paediatric centre, we carry out frequent unannounced in situ simulations. While conducting simulations on acute wards, we have encountered a variety of latent safety threats (LSTs) and barriers to effective patient care. There are numerous off-ward areas in the hospital in which children are assessed and may receive treatment. Some of these areas are difficult to access and are located in parts of the hospital with which staff may be unfamiliar. We designed a project to determine how prepared staff working in these areas would feel if required to manage an unwell child in an emergency. We explored this further using simulation to detect any potential barriers to the effective management of emergencies and to initiate a process by which these could be addressed. The aim of the project was to develop systems to improve patient safety and ensure efficient care could be delivered throughout the entire hospital.


The project was registered with the Standards, Quality and Audit Department and our Service Manager was consulted. We conducted surveys in five off-ward areas. We asked staff about their previous resuscitation training and whether they had any previous experience of managing emergencies in the area in which they work. We also asked if there was an agreed process for managing emergencies in their area. The departments included were the electroencephalogram (EEG) department, …

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  • Contributors CH wrote first draft which was reviewed by BM, AT and TB. All authors agreed final version before submission.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval The project was registered with the Standards, Quality and Audit Department and our Service Manager was consulted.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Correction notice This paper has been amended since it was published Online First. Owing to a scripting error, some of the publisher names in the references were replaced with ’BMJ Publishing Group'. This only affected the full text version, not the PDF. We have since corrected these errors and the correct publishers have been inserted into the references.

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