P22 Operation black rain: a collaboration between healthcare and police CBRN simulation

Abstract

<h3>Background</h3> Chemical, biological, radiological and nuclear (CBRN) incidents either by accidental or deliberate release has been cited as affecting as many as 9.7M globally in 2016¹. ASSERT Centre, UCC and An Garda Síochána (Police) collaborate on a pilot project to assess the suitability of high fidelity simulation to CBRN training for emergency responders. <h3>Summary of work</h3> The busy ED simulation, involved combination of simulated patients, trained actors, and human simulators, where Gardaí had to maintain the safety of patients and staff in a rapidly escalating situation, including the containment and management of a potentially dangerous biohazard which incapacitated several people. The learning objectives were to assess initial response and actions to suspected CBRN incident, review safety protocols and scene management of CBRN team, and to develop CBRN awareness prompt card and guidance document. A further aim of the project was to share knowledge between organisations and build inter-agency collaboration. Key stakeholders from all the emergency services, military, voluntary services, health service and pre-hospital care were invited, to view live, and evaluate the training exercise. The stakeholders remotely viewed in real-time, this was followed by an expert-led debrief and discussion. The exercise was evaluated using Kirkpatrick’s training evaluation model², with the view to acceptability and transferability of training, to inter-agency training on a larger scale. <h3>Summary of results</h3> 96% evaluated the training as highly realistic, while 100% rated the objectives succeeded in raising CBRN awareness. 98% agreed that there was learning in the simulation transferable to their own organisation, and 89% increased their knowledge and learning as a result. The most frequently cited remarks on new learning were the benefits of inter-agency collaboration, communication and teamwork. 65% stated that their behaviour to their job will change. 72% stated that it is very likely that the simulation exercise will improve work practices within their organisations, while 91% anticipated an improvement in the collective response of the responding agencies. <h3>Discussion</h3> The threat of CBRN exposure to our populations is ever increasing. However, globally the availability of courses is not widely accessible to all front-line staff, especially in healthcare². There is an increasing need for inter-agency interoperability to strengthen the ability to detect, prepare for, respond to, mitigate and recover from such emergencies. <h3>Conclusions</h3> This pilot demonstrated that high fidelity simulation training is acceptable to CBRN training. Furthermore, the wide inter-agency evaluation of the training suggests that the training is transferable across first-responding agencies. <h3>References</h3> Kako, M., Hammad, K., Mitani, S., &amp; Arbon, P. (2018). Existing Approaches to Chemical, Biological, Radiological, and Nuclear (CBRN) Education and Training for Health Professionals: Findings from an Inttegrative Literature Review. <i>Prehospital and Disaster Medicine</i>;33(2). 182–190. Kirkpatrick, D. (1994). Evaluating Training Programs: The Four Levels. Berrett-Koehler: San Francisco.

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