Impact of Obstetric Emergency High-Fidelity Simulation on Maternity Nurses' Self-Efficacy in the Rural Hospital Setting

Abstract

The purpose of this study was to explore the impact of an obstetric emergency high-fi delity simulation on maternity nurses' perceived self-effi cacy levels at three different time points. Study Design: We used a quasi-experimental, repeated measures design. Methods: A convenience sample of maternity nurses recruited from three institutions within a single rural health care system participated in simulation exercises at an academic high-fi delity simulation center. They completed the Obstetric Nursing Self Effi cacy survey before, immediately after, and 2 months following the simulation. Results: Twenty-nine nurses were included in the analysis. All were women and Caucasian. Most (72.4%) had a baccalaureate nursing degree, with an average nursing experience of 11 years (range 1 to 44 years), and <5 years of OB experience (55.

Obstetric Nurses’ Self-Efficacy, Demographic Characteristics, and Family-Focused Care during Simulated Events

“…An unexpected complication may be perceived as a traumatic event by the patient and family. The use of FFC simulation scenarios that center on preventing and/or intervening during an emergent OB event can support the development of a nurse's self-efficacy and FFC skill in the management of OB emergency situations (Ehmke et al, 2021;Sanchez Expósito et al, 2017;Van Gelderen et al, 2019). Increased self-efficacy may be reflected in improved care provided to birthing women and families.…”

“…The study findings support that increasing OB nurses' selfefficacy strengthens an increase in FFC. Educational opportunities, particularly simulation scenarios that incorporate family concerns, provide the ability to develop knowledge and thinking, which in turn may positively influence patient outcomes (Ehmke et al, 2021). A challenge to this perspective is that during OB emergencies, nurses may shift their focus to the emerging physiologic needs of the birthing woman, inhibiting FFC.…”

“…Simulation is an effective pedagogy for teaching nurses to manage OB emergencies while providing FFC. Simulation scenarios concentrated on FFC during OB emergencies enable learners to balance the patient's need for care during physical declination with the family's need for support during a crisis (Ehmke et al, 2021). When developing simulation scenarios about complex, emergent events, educators need to make sure that families are incorporated into the care, and not overlooked as nurses manage the patient's physiologic needs.…”

“…Skill development via simulation has become a widely accepted and effective teaching modality to improve nursing knowledge, skills, and communication, and has been linked to improvement in FFC (Van Gelderen et al, 2016). Simulated learning environments can improve clinical performance (Christian & Krumwiede, 2013;Nelissen et al, 2017) and ability to intervene during life-threatening concerns (Christian & Krumwiede, 2013;Nelissen et al, 2017), and enhance self-efficacy (Ehmke et al, 2021;Egenberg et al, 2017;Irby et al, 2017). Simulation that includes FFC increases proficiency and comfort with carrying out difficult conversations with families (Irby et al, 2017;Sanchez Exposito et al, 2017).…”

“…Participants rate their self-efficacy level as completely sure (4), very sure (3), moderately sure (2), slightly sure (1), and not at all sure (0), for a possible total of 72 points. Reliability of the ONSE scale for nurses has a Cronbach's alpha of .98 (Ehmke et al, 2021).…”