An Exploration of the use of Simulation Education in Establishing and Maintaining Nurse Competency in the Maintenance Care of Centrally Inserted Vascular Access Devices in the Critical Care Setting

2.50
Hdl Handle:
http://hdl.handle.net/10755/237351
Category:
Abstract
Type:
Research Study
Title:
An Exploration of the use of Simulation Education in Establishing and Maintaining Nurse Competency in the Maintenance Care of Centrally Inserted Vascular Access Devices in the Critical Care Setting
Author(s):
Nailon, Regina
Lead Author STTI Affiliation:
Gamma Pi-at-Large
Author Details:
Regina Nailon, PhD, RN; Email: rnailon@nebraskamed.com; Office Phone: 402-552-6561
Abstract:

The purpose of this quasi-experimental pilot study was twofold: to determine the feasibility and effectiveness of using video simulation education to establish and maintain critical care nurse competency in the maintenance care of centrally inserted vascular access devices (CVAD) in the adult intensive care unit (ICU) setting in an effort to enhance reduction of central line associated blood stream infections (CL-BSI).  It was hypothesized that: 1) nurses who viewed the simulations via DVD technology would –post simulations – more frequently display behaviors that maintained the integrity of the CVAD and enhanced the patient’s protection from potential risk for CL-BSI related to the nurse’s maintenance care when compared with the behaviors of nurses who did not view the simulated vignettes;  and 2) self-reported CVAD-related care behaviors would demonstrate change in a positive direction from baseline to 6 months in the experimental group compared with the control group.

Thirty-three registered nurses working in one of three adult ICUs at a Midwest, academic medical center were recruited. One of the ICUs was randomly assigned as the experimental group to receive simulation education. Participants from this unit viewed 4 simulated patient scenarios related to maintenance care of CVAD and each session was followed with comprehensive debriefing.

Observational data were collected from all experimental group RNs at baseline and from a randomly drawn sample of all participants on a monthly basis for 6 months. Comparisons were made to determine how statistically significantly different the units were (experimental at its baseline, and control groups who had not viewed the DVD). Several statistically significant differences in behaviors requiring prompting were found between the experimental group and the two control groups in the areas of medication administration, and changing CVAD dressings (p< .01).

While there have been multiple studies which have examined self-reported changes in competence following simulation training, the literature is limited by the lack of studies in which  objective measures of competence were conducted following simulation education. Behavioral change requires knowledge and skills, as well as an attitude that is geared toward doing the right thing. This research study addressed some of these critical gaps in knowledge; most notably, by including observations of nurse behaviors following simulation education and comparing those behaviors to nurses who did not receive the DVD-delivered simulated education to help resolve the dilemma of knowing whether or not simulation education changes a nurse’s knowledge and behavior. This study has shown that use of simulation education delivered via DVD technology provides a cost-effective and sustainable means of educating nurses regarding the appropriate maintenance care behaviors related to CVAD.

 

 

Keywords:
CLABSI; simulation; central line
Repository Posting Date:
6-Aug-2012
Date of Publication:
6-Aug-2012
Sponsors:
Sigma Theta Tau International
Description:
2010 Sigma Theta Tau International/Joan K. Stout, RN, Research Grant
Note:
The Sigma Theta Tau International grant application that funded this research, in whole or in part, was completed by the applicant and peer-reviewed prior to the award of the STTI grant. No further peer-review has taken place upon the completion of the STTI grant final report and its appearance in this repository.; This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen
dc.type.categoryAbstracten
dc.typeResearch Studyen
dc.titleAn Exploration of the use of Simulation Education in Establishing and Maintaining Nurse Competency in the Maintenance Care of Centrally Inserted Vascular Access Devices in the Critical Care Settingen_US
dc.contributor.authorNailon, Regina-
dc.contributor.departmentGamma Pi-at-Largeen
dc.author.detailsRegina Nailon, PhD, RN; Email: rnailon@nebraskamed.com; Office Phone: 402-552-6561en
dc.identifier.urihttp://hdl.handle.net/10755/237351-
dc.description.abstract<p>The purpose of this quasi-experimental pilot study was twofold: to determine the feasibility and effectiveness of using video simulation education to establish and maintain critical care nurse competency in the maintenance care of centrally inserted vascular access devices (CVAD) in the adult intensive care unit (ICU) setting in an effort to enhance reduction of central line associated blood stream infections (CL-BSI).  It was hypothesized that: 1) nurses who viewed the simulations via DVD technology would –post simulations – more frequently display behaviors that maintained the integrity of the CVAD and enhanced the patient’s protection from potential risk for CL-BSI related to the nurse’s maintenance care when compared with the behaviors of nurses who did not view the simulated vignettes;  and 2) self-reported CVAD-related care behaviors would demonstrate change in a positive direction from baseline to 6 months in the experimental group compared with the control group.</p> <p>Thirty-three registered nurses working in one of three adult ICUs at a Midwest, academic medical center were recruited. One of the ICUs was randomly assigned as the experimental group to receive simulation education. Participants from this unit viewed 4 simulated patient scenarios related to maintenance care of CVAD and each session was followed with comprehensive debriefing.</p> <p>Observational data were collected from all experimental group RNs at baseline and from a randomly drawn sample of all participants on a monthly basis for 6 months. Comparisons were made to determine how statistically significantly different the units were (experimental at its baseline, and control groups who had not viewed the DVD). Several statistically significant differences in behaviors requiring prompting were found between the experimental group and the two control groups in the areas of medication administration, and changing CVAD dressings (p< .01).</p> <p>While there have been multiple studies which have examined self-reported changes in competence following simulation training, the literature is limited by the lack of studies in which  objective measures of competence were conducted following simulation education. Behavioral change requires knowledge and skills, as well as an attitude that is geared toward doing the right thing. This research study addressed some of these critical gaps in knowledge; most notably, by including observations of nurse behaviors following simulation education and comparing those behaviors to nurses who did not receive the DVD-delivered simulated education to help resolve the dilemma of knowing whether or not simulation education changes a nurse’s knowledge and behavior. This study has shown that use of simulation education delivered via DVD technology provides a cost-effective and sustainable means of educating nurses regarding the appropriate maintenance care behaviors related to CVAD.</p> <p> </p> <p> </p>en_GB
dc.subjectCLABSIen_GB
dc.subjectsimulationen_GB
dc.subjectcentral lineen_GB
dc.date.available2012-08-06T12:54:55Z-
dc.date.issued2012-08-06-
dc.date.accessioned2012-08-06T12:54:55Z-
dc.description.sponsorshipSigma Theta Tau Internationalen
dc.description2010 Sigma Theta Tau International/Joan K. Stout, RN, Research Granten_GB
dc.description.noteThe Sigma Theta Tau International grant application that funded this research, in whole or in part, was completed by the applicant and peer-reviewed prior to the award of the STTI grant. No further peer-review has taken place upon the completion of the STTI grant final report and its appearance in this repository.en
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item.-
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