Escape rooms show value in training health workers infection control safety

Researchers say the same team-building and problem-solving skills individuals foster while playing escape room simulation games can be used to help healthcare staff improve their adherence to infection control measures.

Central Texas Veterans Health Care System staff nurses Gracia Boseman and Kristy Causey in 2017 created a zombie-themed high consequence infectious disease escape room as a way of boosting attendance to voluntary infection prevention and control education programs.

The escape room led to a sharp rise in attendance to training. Participation went from an average of 20 clinical staff members per session to 189 clinical and non-clinical workers, training a total of more than 1,100 employees over three years. But the scenario Boseman and Causey created also led to increased adherence to infection control practices.

Results of a study of the program introduced Monday during the 48th Annual Conference of the Association for Professionals in Infection Control and Epidemiology found a reported 61% increase in handwashing among escape room participants and 21% rise in the use of personal protective equipment.

“Education and learning in healthcare can be fun and still provide for some amazing outcomes,” said Causey, who serves as simulation educator for CTVHCS.

A total of six different escape room training scenarios have been developed since 2017, with all but one focused on infection control during an outbreak.

For the escape room studied, participants were given a pandemic flu scenario and were asked to choose the appropriate PPE to use before entering the escape room. Once inside, participants worked as a team to find clues about the illness within a time limit of 15 to 30 minutes.

As word spread about the popularity of the escape room training, Causey said other Veterans Administration health systems inquired on how to set up their own models. Causey and Boseman have provided consulting input to seven Veteran health care systems around the country to help them replicate the escape room as part of their infection prevention training.

Causey said one of the biggest challenges for any system looking to create their own escape room models is the need to maintain its focus as an educational tool and to remain on the topic trying to be conveyed throughout.

“With escape rooms there are many different paths you can go down and it doesn’t really hold the focus,” Causey said.

In an ironic twist, escape room sessions planned for 2020 were cancelled due to COVID-19. Causey said those who had participated in the program prior to the pandemic were noticeably more active in establishing infection control policies and procedures during COVID-19 preparation activities like setting up drive-thru testing sites.

Using escape room simulations as an education tool for healthcare workers has been used by other providers in recent years. In 2017, nurses at Penn Presbyterian Medical Center in Philadelphia developed an escape room to help educate hospital staff on proper care of patients with sepsis.

Boseman said plans are underway to resume escape room classes by October, with the program expanded to larger spaces and to tackle other health emergency scenarios. She felt the experience of going through a real-life pandemic would not diminish the appeal of participating in an escape room simulation of an outbreak.

But she said the health system was looking into the possibility of incorporating new modalities as entertaining training tools, like developing scenarios similar to the popular “Hunt A Killer” murder mystery games.


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