AB281. SOH26AB_0210. Enhancing patient safety through multidisciplinary paediatric simulation: a quality improvement initiative at University Hospital Limerick

Background: Simulation is an evidence-based tool for strengthening technical and non-technical skills, and its value is amplified when multiple specialties train together. We implemented a monthly paediatric multidisciplinary simulation programme in University Hospital Limerick to rehearse high-stakes scenarios and strengthen team preparedness for time-critical emergencies. We aimed to design and assess high-fidelity simulations for use in the paediatric setting.

Methods: We designed a series of high-fidelity simulations to reflect rare but important clinical conditions and assess specific non-technical competencies. Simulations were delivered by paediatricians, anaesthesiologists, emergency medicine trainees, and paediatric/emergency department nursing staff. The first scenario simulated the management of a 14-year-old with a suspected overdose/alcohol intoxication in an adult emergency department resuscitation bay. The second involved the resuscitation of an 8-year-old with refractory anaphylaxis progressing to cardiac arrest. Post-simulation surveys were distributed to all participants and observers to assess perceived clinical utility.

Results: Debriefing sessions highlighted several non-technical issues that significantly supported team learning. These included failures in closed-loop communication, unclear/suboptimal role assignment, and, in one scenario, anchoring bias linked to incomplete primary assessment. Subsequent simulations demonstrated improvements in communication, coordination, and overall team confidence. Survey feedback was highly positive, with strong agreement on clinical utility increasing from 62% in the first session to 87% in the second. Participants particularly valued the realistic, multidisciplinary nature of the simulations and expressed interest in continuing the series.

Conclusions: Managing critically ill children in non-specialist centres substantially magnifies the risk associated with rare clinical scenarios. Strengthening non-technical skills through multidisciplinary simulation is therefore essential to improving team preparedness and ensuring safer, more coordinated responses in high-stakes paediatric emergencies.

Keywords: Multidisciplinary; simulation; non-technical skills; paediatrics; emergency