2017 – Endowment Fund Awards – ‘The Virtual Operating Room’ and ‘The Fear-Fighting Toolkit’

The Virtual Operating Room: Developing a Virtual Reality Simulation for Perioperative Nursing Education in Neurosurgery Craniotomy

Team: Linda Nguyen and Dr. Clyde Matava

The operating room isn’t always the best classroom. That’s especially true for craniotomies in which nurses are elbow-to-elbow with surgeons and anesthesiologists, anticipating every surgical need. It’s demanding high-stakes work. Plus, most craniotomies are unplanned emergencies. Nurses on neurosurgery rotations often rush into the operating room, off-guard and unprepared.

Linda Nguyen, the Interprofessional Education Specialist for the Operating Room, knew there had to be a better way. So she started digging until she found her inspiration right here at SickKids – Dr Clyde Matava. In 2014 Dr Matava co-founded the Collaborative Human Immersive Interaction laboratory (CHISIL), a joint project between SickKids, Sunnybrook, and the University of Toronto that uses virtual reality (VR) for everything from patient education to medical simulations. It was a perfect fit.

Two years and one endowment grant later, Linda has a fully functional VR simulation. Now nurses on neurosurgery rotation don’t have to wait months to assist in a craniotomy. They just turn on a computer program, attach a headset, and they’re there – inside a virtual operating room, practicing. “It just creates a safe, consistent environment for learners”, Linda says. And that’s all thanks to the alumni who fund research like Linda’s and who make leaps in nursing education like this possible.

The Fear-Fighting Toolkit: A Toolkit for Caring for Patients with Anti-NMDAR Encephalitis and Their Families

Team: Eugenia Law, Michelle Peralta, Dr Arlette Lefebvre, Joley Johnstone, Dr Ann Yeh, Katanya Fuerst, Daniela Bruce, Kathryn Miller and Sarah Alisch

Eugenia Law’s fellow 5C nurses weren’t just stressed – they were afraid. The problem was anti-NMDAR encephalitis, a disease in which the immune system creates antibodies that attack healthy cells, including the brain’s NMDA receptors, which control electrical impulses. The result? Seizures and psychosis. Radical personality changes and violet mood swings. for families, it’s a tragedy: for nurses, it’s unpredictability and stress and fear.

Eugenia saw first hand how patients went from calm and complacent to delirious and violent with little to no warning. And when patients lashed out or lost control of their limbs, nurses like her had to restrain them – a difficult often dangerous process. “Things happen,” Law explains. “Someone gets kicked or slapped.” The situation was untenable, both for nurses and for patients. So Eugenia decided to do something about it. With the help of a generous grant from the Alumnae Association of the School of Nursing Endowment Fund she began working on a toolkit to better prepare nurses to treat patients with anti-MNDAR encephalitis. And it’s making a difference.

It started with education, including an in-service session on restraints and a class on managing agitation. For more anti-NMDAR encephalitis-specific content Eugenia created a shareable digital folder with everything from trigger recognition to de-escalation strategies like mindful breathing. Next up is a step-by-step treatment plan. “It’s a kind of a check list that we can have above the patient’s bed that family can se and everyone can then work together to individualize treatment”, Eugenia says. Once finished it will mean better care for patients and happier, safer nurses.

(The information above is taken from: “Remembering the Past. Redefining the Future. The Alumnae Association of the school of Nursing, 2018 Impact Report)