An evidence-based practice project for recognition of clinical deterioration: Utilization of simulation-based education

Abstract

Background: As more complex patients are hospitalized, the need for highly skilled and competent nurses to recognize clinical deterioration becomes more apparent. The literature supports the use of simulation-based education to enhance the recognition of clinical deterioration. The purpose of this evidence-based practice project was to utilize simulation as an educational modality to improve the knowledge of registered nurses in the recognition of clinical deterioration among their patients.Methods: This evidence-based practice project was conducted from May through June 2013 in a 900-bed facility. Participation was voluntary and included 15 medical-surgical, procedural, and post-anesthesia care unit registered nurses. Simulation-based education was utilized for assessing the recognition, management, and reporting of clinical deterioration by nurses while supporting learning in a safe environment. Each participant managed two simulated patients in deteriorating states. Baseline performance was obtained during the initial simulation scenario by utilizing RAPIDS, a validated tool that evaluates assessment, management, and clinical deterioration reporting. A post-simulation debriefing and education session occurred that included a review of all required critical action elements. Debriefing was followed by a second post-intervention simulated clinical deterioration scenario. Results:The results indicated statistically significant improvement in mean assessment and management scores when the post-intervention results were compared with baseline [t ( 14) =2.04, p = .03]. Post-intervention reporting scores were also improved, although this change was not statistically significant.Conclusions: Simulation-based education may be an effective strategy for impacting a nurse's ability to recognize clinical deterioration and thereby allow for timely intervention.

Effect of realistic simulation combined to theory on self-confidence and satisfaction of nursing professionals

“…Simulation-based education demonstrates improving nurses' confidence, knowledge and communication, especially when there is an emphasis of patients in clinical decline [17][18][19][20][21][22] . A similar finding was identified in the present study where professionals who experienced the strategy of simulation combined to theory had a significant increase in self-confidence in relation to the group that experienced only the simulation.…”

Effectiveness of a simulation activity on knowledge about glucose monitoring and hypoglycemia management: a pre-post intervention study

“…The improvements found in the post-test show that the intervention had a positive effect on knowledge acquisition and assimilation. A similar study carried out at the Texas Medical Center has found a statistically significant improvement in post-intervention results compared to the pre-intervention [t (14) = 2.04, p = .03] (Bell-Gordon et al, 2014).…”

Simulation Center Partnership:A University and Community Hospital Collaboration for Healthcare Education

“…The National League for Nursing (NLN) endorsed this study and the findings (2015).Furthermore, they promote simulation as an effective and evidence-based method for fostering critical thinking and reasoning skills for patient care [2]. In addition to those benefits of simulation, this methodology has been found to facilitate teamwork and mastery of practical skills related to clinical care [3][4][5]as well as cognitive skills [6,7].Simulation based learning has been found to be an effective tool to improve early recognition of clinical decline [8]and build confidence and knowledge in critical care situations [9].For example, students are paired together as a teaching strategy to foster team communication and collaboration. Participant preparation is necessary for students to successfully accomplish simulation objectives [10].Unlike a classroom setting or a paper and pencil test, simulation allows the learner to function in an environment that is as close as possible to an actual clinical situation and provides them the opportunity to "think on their feet, not in their seat" [11].…”