1. Lopez, Connie MSN, CNS, RNC-OB, CPHRM

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1. What are the significant professional milestones in your NPD journey/career?



CL: The turning point in my professional nursing career was when I decided to focus my master's thesis on simulation for perinatal emergencies, and was able to develop and implement the first in situ simulation program in labor and delivery at the university. Later, as an educator in perinatal services for a Kaiser Permanente (KP) medical center, I observed a simulation of an emergency cesarean section in which the healthcare team took care of the patient manikin as if she were a real patient. I was so impressed and knew this was the work I was meant to do, so I immediately volunteered to be the medical center's team leader for simulation. I am currently KP's national leader for simulation and support simulation programs for KP regions across the United States.


2. How have you seen the specialty of NPD grow/evolve/change during your career?



CL: I believe the November 1999 publication of the Institute of Medicine's report, "To Err is Human: Building a Safer Health System," changed the focus of nursing and nursing professional development (NPD) forever. It forced healthcare professionals to question the effectiveness of our educational programs and how they help reduce errors and improve patient safety. The report outlined the far-reaching effects of medical errors, including loss of patient trust and diminished patient and health professional satisfaction. It has led us to rethink our safety systems and recognize that change can only occur with the full commitment of all clinicians and administrators. Since the Institute of Medicine's report, patients have come to expect-and healthcare professionals are more focused on delivering-affordable, high-quality care in which patient safety is the highest priority.


Leadership commitment and support have been essential to the successful launch of KP's patient safety program. However, the program's widespread implementation is due to the collaboration of team members at all levels across the organization (doctors, nurses, unit secretaries, ancillary staff, etc.). Their participation in interprofessional education and department simulations, along with their focus on making patient safety their highest priority, are the key to the program's growth and success.


3. What do you see as significant trends or gaps in NPD practice, from your perspective as an expert in simulation?



CL: As a national risk manager leading simulation education across KP, I work with other KP educators and quality leaders on developing patient safety programs that will proactively prevent medical errors, reduce adverse events, and promote a culture of safety. I believe there has been a revolution in nursing education. Trends include a shift from training the individual nurse to training the entire healthcare team, along with a shift from just treating the illness to an increased focus on patient safety and the prevention and mitigation of errors. We are using simulation to train teams in procedures and validate competence without involving or endangering actual patients, and educational curriculums now include simulation training in clinical settings as well as in the classroom.


KP's perinatal shoulder dystocia program is an example of how these trends are being applied. Training of interprofessional teams includes participation in didactic and skills stations followed by team simulations. The didactic includes discussions around clinical practice to ensure a shared mental model of care. Skills stations provide the opportunity for teams to practice their skills and close any gaps. The simulations "tie it all together." Teams apply their knowledge and skills and receive feedback in a safe environment, with a focus on collaboration, teamwork, and communication.


4. What insights can you share related to the value of NPD in healthcare organizations now and in the future?



CL: I believe nurse professional development leaders have the potential to use simulation training to decrease preventable "never events," which have a devastating effect on patients and families, jeopardize the reputation of healthcare organizations, and also affect healthcare workers who often become second victims of these traumatic events. Using simulation for assessment of professional skills, nursing educators can identify vulnerabilities in personnel and in care systems so that fixes can be put into place before an actual adverse event occurs. Providing in situ hands-on training for nursing staff and healthcare teams can ensure competency prior to staff caring for actual patients and has been shown to improve rapid recognition and management of clinical problems through the development of structured communication skills, processes, and procedures. Since the inception of KP's perinatal simulation and patient safety programs, our organization had a greater than 50% decrease in birth injuries and claims. Healthcare professionals are hired to do their jobs based on their individual skills and expertise. Simulation helps a "team of experts" become an "expert team."


5. What advice do you have for NPD specialists in the context of today's healthcare and learning environments?



CL: If we do not adopt engaging learning environments such as simulation throughout our organizations, we will be missing the opportunity to proactively identify systems issues without involving our patients. Appropriate training and preparation will enable staff to bring an educated response to critical events when they happen rather than simply reacting in the moment. Nursing educators can have a direct impact on the competence and performance of the entire healthcare team. This represents a unique opportunity and responsibility to lead in the effort to improve patient care and safety.