零伤害：不可能还是“我可能”？

阿什利（Ashley）在西雅图的1级创伤中心工作。她担任新护士的第一份工作。那天晚上她的一位病人是一名老年男性。他被带到那里进行了伤口Vac（真空辅助封闭），这使他受伤，使他遭受了严重的骨科创伤，塌陷的肺部和骨盆碎的骨盆。他刚刚从手术中出来，当他开始表现出肺栓塞迹象（PE）时，他开始从麻醉中恢复意识。

Ashley was the first to recognize that the patient was suffering from a PE. When she found that he had no pulse, she immediately took the lead. She quickly assembled a team of available staff, assigned roles, and began directing Cardiopulmonary Resuscitation (CPR). “I had an identical simulation at WSU where the patient had a PE. I was very surprised by my ability to remain calm and level-headed, but I could…because I had done it before,” Ashley said.

For nearly 30 minutes, Ashley and her team performed CPR. The attending physicians and anesthesiologist, who had left after the surgery, returned and began managing the code. After repeated rounds of compressions and team members rotating through using high performance CPR protocols, the patient finally returned to spontaneous circulation. He was going to live.

在随后的几个小时里，阿什利的同伴护士认可她抓住了该计划。“他们被吹走了；我从新护士到运行代码的护士。当他们问我如何知道发生了什么事时，我分享了与类似模拟的经验。我以为在我的第一个代码中，我会感到非常不舒服。但是，在那一刻，我从未变得更加平静和收集。”阿什利说。

Ashley’s story illustrates how simulation is being used in healthcare today. Historically, providers were confined to learning by treating real patients. The National Council of State Boards of Nursing (NCSBN) now recommends that simulation can be used to replace up to 50% of required clinical hours. Across healthcare, simulation is now being used, not only to teach clinical skills, but to teach critical thinking, leadership, and teamwork skills. “See one, do one” is making room for “Simulate twice, act once.”

We would like to thank Ashley and the simulation staff at WSU for their mutual contribution to the goal of zero preventable harm. It was because of their combined dedication and efforts--students and educators alike--that Ashley’s first code was not her first. If it were not for Ashley’s simulation experience, she may not have been able to act as decisively and boldly as she did.在模拟和患者安全社区中，您就是我们所有人说“我可能”的含义。