When the first cases of COVID-19 began to appear in the First Nations and Inuit communities of Northern Ontario, planning was underway to answer the question: “How are we going to cope?” A Nursing Practice Advisor with the First Nations and Inuit Health Branch (FNIHB), Craig O’Brien oversees nursing stations in many of the First Nations and Inuit communities across the province. In the 40 stations supported by the FNIHB, there are no hospitals, a doctor visits only once a month, and it can take hours or even days to get critically ill patients safely to hospital. “We wanted to know what to do in a worst-case scenario – if we had a patient who was struggling to breathe and didn’t have the ability to intubate him,” says Craig. The answer came in the form of new equipment – ​​oxygen concentrators, nasal prongs and masks – and an innovative training partnership with Sunnybrook. Immersive simulation-based training “Clinic nurses complete busy two-week shifts with little time to attend training sessions that guide them in using their new equipment,” explains Agnes Ryzynski, Director of the Sunnybrook Canadian Simulation Center (SCSC). Founded in 1995 as a Canadian first, SCSC trains more than 3,000 students, health professionals and researchers annually in patient care situations. “It prompted us to think about how we could use technology to deliver online, flexible and immersive educational experiences focused on the management of COVID-19 patients experiencing respiratory distress,” says Agnes. The SCSC team, (including Agnes Ryzynski, Director of Medicine and Research Dr. Fahad Alam, Simulation Educator Susan DeSousa, Simulation Specialist Victoria May, and VR Developer Kyle Wilcocks) and Sunnybrook Respiratory Therapist Julie Nardi collaborated with FNIHB to design and to deliver the innovative program to 21 remote stations in Ontario. Clinic staff use their smartphones equipped with a cardboard virtual reality lens to view the four 3D training videos. They can access the tools 24/7 using a QR code embedded in each piece of equipment. The project was funded by donors who have supported Sunnybrook’s COVID-19 response and education. The videos have been viewed more than 350 times to date. “The feedback I got from the nurses was that the training videos were helpful in explaining the oxygen pathway and were easily accessible using their phones or devices when they could watch,” says Craig.
An immersive 360-degree interactive image was developed to allow viewers to explore the room and view tips for managing a patient with respiratory failure/oxygenation. Development of new protocols In addition to providing access to healthcare education, the videos inspired the FNIHB team to develop a new protocol for the safe storage and use of oxygen therapy in a remote setting. “In a crisis, there’s no time to pull out a manual. Sunnybrook’s expertise has been invaluable in helping frontline nurses in northern Ontario’s remote First Nations communities provide the safest, most informed care to their patients,” says Craig. “We are very grateful.”