High-Fidelity Simulation Effect on Nurses' Identification of Deteriorating Pediatric Patients

•Intervention: Nurses participated in HF simulations of deteriorating patients.•Evaluation: Nurses’ accurate recognition of deterioration and patient outcomes.•84.8% of nurses’ PEWS scores prior to ACT Team and Code Blue events were accurate.•Among 92 ACT Team and Code Blue events, 72.2% resulted in PICU transfers.•Total number of simulations was not related to PEWS accuracy or PICU transfers.

BackgroundWe evaluated the effects of high-fidelity pediatric simulation experiences on nurses' early recognition of deterioration and patient outcomes.MethodPediatric nurses (n = 83) participated in a 12-month quality improvement project.ResultsAmong 92 rapid response team/Code Blue events, 72.2% resulted in pediatric intensive care unit transfers; 84.8% of nurses' prior Pediatric Early Warning Score scores were accurate. The number of simulations that nurses completed during the study was not related to Pediatric Early Warning Score accuracy or pediatric intensive care unit transfer rates.ConclusionsAlthough simulations did not affect these outcomes, this is the first study to link pediatric high-fidelity simulation experiences to individual nurses' clinical decision-making practices and patient outcomes.