Table 1.

Simulation in Healthcare-Acquired Infection Prevention: Review of Medical Literature

Infection Prevention Measure	Trainer	Learner	Training	Outcome	Reference
General
Hand Hygiene	Critical care physicians, hygienist nurses	Second- and third-year medical students	Application of fluorescent alcohol-based hand rub under UV-C	Improvement in complete application of alcohol hand rub	Dray et al 7
	Does not specify	Residents, nurses, nursing assistants			Ghazali et al 8
	Chief nurses	Healthcare workers			Lehotsky et al 9
Standard precautions	Does not specify	Nursing students	Donning and doffing of PPE; performing nursing practices on standardized patients or peer role play	Increase in knowledge, awareness of standard precaution and infection control performance	Kim et al 10
Disaster/outbreak preparedness
PPE	Educator, director of infection control	Nurses, physicians, respiratory therapists	Cardiac arrest scenario in patient with SARS	Identified errors in infection control measures	Abrahamson et al 11
	Does not specify	Physician, nurses, technicians	Deterioration of patient with suspected Ebola	Improvement in post-intervention score	Abualenain et al 12
	Physicians	Multidisciplinary healthcare workers	Application of PPE; practice of various procedures on patient with Ebola	Increasing sense of security, predisposition, and confidence	Carvalho et al 13
Hand Hygiene, PPE	Nursing champions, simulation team	Nurses, physicians, respiratory therapists	Tracking of surface contamination using UV-C luminescent spray during MRSA outbreak	No new episodes of colonization or infection	Gibbs et al 14
CAUTI
Urinary catheter Insertion	Nurse educator	Medical students	Aseptic technique during insertion of urinary catheter	Lowest CAUTI rate among medical students	Barnum et al 15
	Simulation fellow, senior general surgery residents	Second year medical students	Simulated germs for hand washing, maintenance of aseptic technique during urinary catheterization	Maintained better sterility and had higher technical proficiency score during urinary catheterization	Mittal et al 16
CLABSI
Central venous catheter insertion	Vascular access nurse or physician	Attending physicians, residents	Hands-on practice of insertion of central venous catheter	Decrease in CLABSI rate	Allen et al 17
	Critical care fellows, attending physician	Residents			Burden et al 18
	Neonatologists	Attending physicians, residents			Steiner et al 19
	Does not specify	Internal medicine emergency medicine residents		Fewer CLABSI after intervention Increased cost savings	Barsuk et al 20 Cohen et al 21
	Does not specify	Residents in anesthesia		Improvement in compliance on catheter insertion checklist	Cartier et al 22
	Emergency medicine and critical care attendings	Emergency medicine residents		Improvement in sterile technique performance scores	Hoskote et al 23
	Does not specify	Second- and third-year medical residents		Improvement in sterile technique score	Khouli et al 24
	Anesthesiologist, Pulmonary/critical care physician	Interns, residents, nurse anesthetists		Increase in Likert-scale ratings on aseptic technique	Latif et al 25
	Infection control practitioners, hospital epidemiologist	Medical students, Interns		Increase use of full-size sterile drapes, decrease in rate of catheter-related infection, cost savings	Sherertz et al 26
Central venous catheter maintenance	Nurses	Student nurses	Hands-on practice of maintenance of central venous catheter	No difference in postest score for lecture-based vs simulation based	Aloush et al 27
	Investigator	Nurses		Improvement in compliance bundle score	Hebbar et al 28
	Nurses	Parents of children with cancer		Difference in knowledge score pre-and post-test	Rosenberg et al 29
	Clinical educators	Nurses		Decrease in CLABSI rate	Scholtz et al 30
SSI
Surgical hand disinfection, preparation of surgical field	Surgical nurse, infection preventionist	Medical students, operating room technician trainees	Hands-on practice of operating room entry procedure, surgical hand disinfection, skin preparation	High satisfaction among learners	Breckwoldt et al 31
Surgical hand rub technique	Does not specify	Medical students	Fluorescent solution, hands placed under UV-C light	Improvement in compliance and efficacy of surgical hand rub	Vanylos et al 32
VAP
Oral care	Does not specify	Critical care nurses	Hands-on practice of ventilator bundle related to oral care practices	Increase in knowledge score	Jansson et al 33

Note. UV-C, ultraviolet C; PPE, personal protective equipment; SARS, severe-acute respiratory syndrome; MRSA, methicillin-resistant Staphylococcus aureus; CAUTI, catheter-associated urinary tract infection; CLABSI, central-line–associated blossdstream infection; SSI, surgical site infection; VAP, ventilator acquired pneumonia.