零伤害：不可能或“我可能”？

Ashley的在西雅图的一个Trauma中心工作。她是一个新护士的第一份工作。她的一个患者，那天晚上是一名老年男性。他被带到那里伤口VAC（真空辅助闭合）后伤害，使他留下严重的骨科创伤，塌陷的肺和碎骨盆。他刚从手术中出现，并且当他开始显示肺栓塞症状时，从麻醉时开始恢复意识（PE）。

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.

In the hours that followed, Ashley’s fellow nurses recognized her for seizing the initiative. “They were blown away; I went from new nurse to nurse running the code. When they asked me how I knew what was happening, I shared my experience with the similar simulation. I thought during my first code I would be so uncomfortable. But, in that instant, I have never been more calm and collected,” Ashley said.

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.你是我们所有人在模拟和患者安全社区中的例子，意味着说“我是可能的。”