155 - Heating Up Confidence: MH Escape Room Success

Description: Description of Team

The initiative was designed by the ambulatory surgery centers (ASC) education team in partnership with perioperative leaders. The ASC education team created the simulation to reflect the roles and responsibilities of the multidisciplinary team, including registered nurses, surgical technologists, and patient care technicians.

Preparation and Planning

Traditional education formats often fail to fully engage staff or support long-term retention of critical protocols (Klamm, Volden, & Smith, 2024). The ASC education team developed a hands-on simulation to strengthen malignant hyperthermia (MH) knowledge and boost staff confidence. The escape room structure reflected the urgency and teamwork needed during a real MH emergency, aligning with the healthcare organization's focus on practical, engaging education that supports clinical readiness and patient safety.

Assessment

Educational gaps were identified after annual competency reviews and staff feedback. Results showed that team members felt unconfident in responding to emergencies such as MH. The ASC education team developed learning objectives based on current MH guidelines. Content focused on early recognition of MH symptoms, timely initiation of the MH protocol, and effective use of emergency resources such as the MH cart and dantrolene. Pre-intervention responses highlighted a range of staff confidence levels and reinforced the need for a hands-on, team-based learning experience (Quek et al., 2024).

Implementation

An MH escape room scenario was created, dividing staff into focused, role-diverse groups. Each team raced against the clock to solve clinical clues that mirrored an escalating MH crisis. Objectives included symptom identification, calling for help, locating supplies, mixing dantrolene, and coordinating care. A debrief followed each session to reinforce learning, encourage reflection, and evaluate how the team functioned under pressure. Staff were also surveyed to assess changes in confidence and perceptions of the experience.

Outcome

A total of 114 ASC staff participated in the MH escape room, with 86 completing the post-survey (75% response rate). Respondents included RNs, surgical techs, and PCTs. Most reported feeling confident in identifying MH symptoms (88%), activating the protocol (90%), using the MH cart (98%), and working with the peri-anesthesia team (93%). Less than 7% of the participants expressed neutral or lower confidence levels. Feedback was highly positive: 94% agreed the escape room was engaging and more effective than traditional methods. Ninety-two percent felt it reinforced confidence in managing MH, and 90% supported using this hands-on format for future training. Suggestions included offering more prizes and individual sessions. Less than 5% of participants expressed lower confidence levels or preferred an alternative learning experience.

Implications for Perioperative Nursing

This project demonstrated that gamified, simulation-based learning can enhance perioperative staff readiness for low-frequency, high-risk events. The escape room format improved team communication, clinical judgment, and MH protocol familiarity in a realistic, engaging environment (Anderson, Lavelle, & Reedy, 2021). For perioperative nurses, this approach builds crisis role clarity, rapid-response skills, and a culture of safety. It can be adapted for other emergencies to support ongoing competency in outpatient surgery.