Table 4 ISS to improve clinical skills and outcomes

Andreatta 2011 [87] (US)

Viability and effectiveness of a simulation-based paediatric mock code program on patient outcomes, as well as residents’ confidence in performing resuscitations

Children’s hospital (n = 41)

1. Survival rates

Prospective observational

Quality assessment – moderate (3e)

Barni 2018 [79] (Italy)

Improve management of anaphylaxis

Paediatric ED (n = 30)

1. Clinical management

Prospective observational Quality assessment—good (3e)

Ben-Ari 2018 [80] (Israel)

Improve safety practice of ED sedation

ED (n = 16)

1. Sedation performance scores

Prospective observational Quality assessment: moderate (3e)

Braddock 2014 [90] (US)

Improve clinical outcomes and safety culture

Inpatient units (n = 303)

1. Incidence of septic shock

2. Incidence of respiratory failure

Prospective observational Quality assessment: good (3e)

Coggins 2019 [86] (Australia)

Improve mechanical CPR performance

(n = 112)

1. CPR performance scores

RCT Risk of bias: moderate (1c)

Generoso 2016 [91] (US)

Improve nurses' responses in the first 5 min of in-hospital emergencies

(n = 147)

1. Clinical management

Prospective observational Quality assessment: moderate (3e)

Gibbs 2018 [88] (US)

Diagnose and correct LST to mitigate a methicillin-resistant Staphylococcus aureus outbreak

NICU (n = 99)

1. Hand hygiene

2. MRSA outbreaks

Prospective observational Quality assessment: good (3e)

Hamilton 2015 [93] (US)

Improving technical and interprofessional skills during an emergent simulated open thoracotomy

1. Time taken to complete procedure

Prospective observational Quality assessment: moderate (3e)

Josey 2018 [85] (US)

Survival rates following In-hospital cardiac arrest for hospitals more and less active in in-situ mock code training

26 Hospital sites

1. Survival rates

Prospective observational Quality assessment: good (3e)

Knight 2014 [84] (UK)

Improving survival to discharge and code team performance after paediatric in-hospital cardiopulmonary arrest

(n = 169 patients. CG = 123 / IG = 46)

1. Survival

2. Neurological morbidity

3. Adherence to standards

Observational with historical controls Quality assessment: moderate (3e)

Kobayashi 2012 [81] (US)

Determine baseline performance of ED telemetry for detecting arrhythmias and improve system performance through human factors engineering (HFE)

ED

1. Detection of ventricular tachycardia and sinus bradycardia

Prospective observational Quality assessment: moderate—good (3e)

Lavelle 2017 [2] (UK)

To improve management of medical deterioration

mental health settings (N = 53)

1. Incident rates

Prospective observational Quality assessment: moderate (3e)

Marshall 2015 [94] (US)

To improve team training for postpartum haemorrhage

Community maternity hospitals (n = 22)

1. Clinical management

2. Response times

Prospective observational Quality assessment: moderate (3e)

Sleeman 2018 [92] (UK)

To improve the identification and treatment of hypoglycaemia

Hospital ward

1. Number of incidents

Prospective observational (QI) Quality assessment: low—moderate (4)

Steinemann 2011 [82] (US)

Evaluate the impact of a team training curriculum on team communication, coordination and clinical efficacy of trauma resuscitation

ED (n = 137)

1. Resuscitation time

Prospective cohort Quality assessment: moderate – good (3e)

Sullivan 2015 [83] (US)

Improve retention of cardiopulmonary resuscitation priorities for in-hospital cardiac arrests

(n = 72)

1. Clinical management

2. Response times

RCT Risk of bias: moderate (Ic)

Theilen 2013 [89] (UK)

Evaluate the long-term impact of ongoing regular team training on hospital response to deteriorating ward patients, patient outcome and financial implications

PICU (admissions n = 139)

1. Response times

2. Clinical management

3. Transfer times

Prospective cohort Quality assessment: moderate (3e)