KJA RECOMMENDATION (7th KJA MEETING ON SEP 7, 2017) Project Closure Report N. Sreekanth Nayak, Pavan Sridharan and B Gurumoorthy, Centre for Product Design and Manufacturing, IISc 1 Contents Acknowledgements ....................................................................................................................................... 5 Executive Summary ....................................................................................................................................... 6 1. Introduction .............................................................................................................................................. 7 i. Background .................................................................................................................................................................. 7 ii. Emergence of the NTS Concept ............................................................................................................................ 7 iii. Design and Development of the NTS System.................................................................................................. 7 iv. Structure of the NTS.................................................................................................................................................. 8 2. Content and Scenario Structure .............................................................................................................. 11 i. Learning Objectives of Simulation for Nurses ............................................................................................ 11 ii. Scenario Definition ................................................................................................................................................. 11 A. Beginner Scenarios .......................................................................................................................................................... 12 Hemodynamics - ................................................................................................................................. 12 Ventilator ............................................................................................................................................ 12 Manikin ...................................................................................................................................................................................... 13 B. Intermediate Scenarios .................................................................................................................................................. 14 Example - Hypotension ....................................................................................................................... 15 C. Advanced Scenarios ......................................................................................................................................................... 16 iii. Scenario Difficulty................................................................................................................................................... 18 A. Easy ........................................................................................................................................................................................ 18 B. Medium ................................................................................................................................................................................. 18 C. Difficult.................................................................................................................................................................................. 18 Scenario Scoring .................................................................................................................................................................... 18 3. Product Testing ....................................................................................................................................... 19 Feedback from Nurses - St. John's Medical College Hospital ICU ...................................................................... 20 Demonstration of NTS to Dr. Devi Shetty at KJA on 24th January 2017 ......................................................... 21 Nurses Training- Bangalore Medical College Research Institute ...................................................................... 22 Training Methodology ......................................................................................................................................................... 22 Summary of Feedback from the trainees ................................................................................................................... 23 Sustainable Training Plans ................................................................................................................................................ 24 4. Deployment ............................................................................................................................................. 26 NTS as a Deployable Product ............................................................................................................................................ 26 Status, gaps, critical areas .............................................................................................................................................. 27 Benchmarking/Gaps .................................................................................................................................... 28 Taking NTS to market and its Sustained Development ......................................................................................... 30 2 5. Presentation in the 7th KJA Meeting ................................................................................................... 30 6. Conclusions and Recommendations for Sustained Development and Deployment of NTS ................... 32 Annexures ................................................................................................................................................... 33 Annexure I ................................................................................................................................................................................ 33 Roadmap for translation of NTS to commercial deployment through a start-up ...................................... 33 Annexure II ............................................................................................................................................................................... 34 Annexure III ............................................................................................................................................................................. 37 Nurses Simulation Training Program in BMCRI........................................................................................... 37 - Minutes of the Meeting ............................................................................................................................ 37 Annexure IV ............................................................................................................................................................................. 39 Simulation training Feedback form ............................................................................................................. 39 Annexure VI ............................................................................................................................................................................. 40 3 4 Acknowledgements The project team would like to sincerely thank Dr. K Kasturirangan, hon’ble Chairman, KJA for his valuable guidance and vision of improving the skill of nurses across the country- to deliver better outcomes in healthcare to all. We would like to thank Dr. Mukund Rao, hon’ble Member Secretary, KJA, for his valuable guidance, scientific input and support, to enable us to execute this complex and challenging project. We would like to thank Sister Sherin Susan Thomas, Nurse Mentor in St. John’s ICU, for her insights into nursing education pedagogy, and for scenario content. We would like to thank the administrative staff at KJA for their timely organization of review meetings, prompt communication of the minutes and followup. We would like to thank Dr. S Sachidanand, (Director, Medical Education Dept and Director, BMCRI), Dr. Balaji Pai, (Special Officer, Trauma Care Centre), BMCRI and Dr. Asima Banu (Nodal Officer, Trauma Care Center, BMCRI), for facilitating the training in BMCRI and for their support and encouragement, 5 Executive Summary This report describes the design and development of a medical simulator for nurses to practice diagnosis and procedures that are carried out in a post operative critical care unit (CCU) with an emphasis on cardiac care. The product consists of physical representations of a human patient in the form of a manikin and the instrumentation found in the CCU. Both are integrated with an electromechanical and computational back end. Interaction with clinicians helped define a broad set of requirements of the simulator. Based on these, the cut-outs in the manikin and the physical instrumented modules required were conceptualized and prototyped. The electronics in the physical modules and the software that integrates them were design and developed After a prototype was designed, a database of medical scenarios was created based on