Low-Fidelity, In-Situ Pediatric Resuscitation Simulation Improves RN Competence and Self-Efficacy

Saqe-Rockoff, Ada; Ciardiello, Amanda V.; Schubert, Finn D.

doi:10.1016/j.jen.2019.02.003

Cited by 23 publications

(24 citation statements)

References 28 publications

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“…Sixteen studies were observational; there was one prospective cohort study, five RCTs, and five quasi-experimental studies. Studies were conducted in adult and paediatric emergency and resuscitation teams and departments [ 69 , 71 , 82 , 96 – 105 ], paediatric and neonatal care [ 106 – 112 ], obstetric care [ 24 , 113 – 115 ], ICU [ 116 , 117 ], a post anaesthesia care unit [ 118 ] and a mental healthcare setting [ 2 ]. Where reported, ISS interventions were delivered over periods of one day to 18 months, with training lasting from 30 min to 3 h. Reported sample sizes ranged from 20—750 participants.…”

Section: Resultsmentioning

confidence: 99%

“…Technical scores 2. Performance scores RCT Risk of bias: moderate (1c) Author, date (Country) Research topic Setting and participants Outcome methods and measures Saqe-Rockoff 2019 [ 96 ] (US) Improve nurse’s competence and self-efficacy in paediatric resuscitation scenarios using a low-fidelity simulation ( n = 43) 1. Confidence scores 2.…”

Section: Resultsmentioning

confidence: 99%

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GENESISS 2—Generating Standards for In-Situ Simulation project: a systematic mapping review

et al. 2022

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Background In-situ simulation is increasingly employed in healthcare settings to support learning and improve patient, staff and organisational outcomes. It can help participants to problem solve within real, dynamic and familiar clinical settings, develop effective multidisciplinary team working and facilitates learning into practice. There is nevertheless a reported lack of a standardised and cohesive approach across healthcare organisations. The aim of this systematic mapping review was to explore and map the current evidence base for in-situ interventions, identify gaps in the literature and inform future research and evaluation questions. Methods A systematic mapping review of published in-situ simulation literature was conducted. Searches were conducted on MEDLINE, EMBASE, AMED, PsycINFO, CINAHL, MIDIRS and ProQuest databases to identify all relevant literature from inception to October 2020. Relevant papers were retrieved, reviewed and extracted data were organised into broad themes. Results Sixty-nine papers were included in the mapping review. In-situ simulation is used 1) as an assessment tool; 2) to assess and promote system readiness and safety cultures; 3) to improve clinical skills and patient outcomes; 4) to improve non-technical skills (NTS), knowledge and confidence. Most studies included were observational and assessed individual, team or departmental performance against clinical standards. There was considerable variation in assessment methods, length of study and the frequency of interventions. Conclusions This mapping highlights various in-situ simulation approaches designed to address a range of objectives in healthcare settings; most studies report in-situ simulation to be feasible and beneficial in addressing various learning and improvement objectives. There is a lack of consensus for implementing and evaluating in-situ simulation and further studies are required to identify potential benefits and impacts on patient outcomes. In-situ simulation studies need to include detailed demographic and contextual data to consider transferability across care settings and teams and to assess possible confounding factors. Valid and reliable data collection tools should be developed to capture the complexity of team and individual performance in real settings. Research should focus on identifying the optimal frequency and length of in-situ simulations to improve outcomes and maximize participant experience.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

GENESISS 2—Generating Standards for In-Situ Simulation project: a systematic mapping review

et al. 2022

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“…21 Nursing literature reports a similar lack of exposure to paediatric cases. 22 Despite low exposure to paediatric patients in training, general EDs are responsible for paediatric care in over 80% of cases, as most of these patients do not present to paediatric speciality centres. 23 During the ISS sessions, we uncovered issues regarding familiarity with paediatric dosing, the paediatric resuscitation cart and restocking of paediatric consumables.…”

Section: Discussionmentioning

confidence: 99%

Multiprofessional perspectives on the identification of latent safety threats via in situ simulation: a prospective cohort pilot study

Rusiecki

Walker

Douglas

et al. 2020

BMJ Simul Technol Enhanc Learn

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ObjectivesTo describe the association between participant profession and the number and type of latent safety threats (LSTs) identified during in situ simulation (ISS). Secondary objectives were to describe the association between both (a) participants’ years of experience and LST identification and (b) type of scenario and number of identified LSTs.MethodsEmergency staff physicians (MDs), registered nurses (RNs) and respiratory therapists (RTs) participated in ISS sessions in the emergency department (ED) of a tertiary care teaching hospital. Adult and paediatric scenarios were designed to be high-acuity, low-occurrence resuscitation cases. Simulations were 10 min in duration. A written survey was administered to participants immediately postsimulation, collecting demographic data and perceived LSTs. Survey data was collated and LSTs were grouped using a previously described framework.ResultsThirteen simulation sessions were completed from July to November 2018, with 59 participants (12 MDs, 41 RNs, 6 RTs). Twenty-four unique LSTs were identified from survey data. RNs identified a median of 2 (IQR 1, 2.5) LSTs, significantly more than RTs (0.5 (IQR 0, 1.25), p=0.04). Within respective professions, MDs and RTs most commonly identified equipment issues, and RNs most commonly identified medication issues. Participants with ≤10 years of experience identified a median of 2 (IQR 1, 3) LSTs versus 1 (IQR 1, 2) LST in those with >10 years of experience (p=0.06). Adult and paediatric patient scenarios were associated with the identification of a median of 4 (IQR 3.0, 4.0) and 5 LSTs (IQR 3.5, 6.5), respectively (p=0.15).ConclusionsInclusion of a multidisciplinary team is important during ISS in order to gain a breadth of perspectives for the identification of LSTs. In our study, participants with ≤10 years of experience and simulations with paediatric scenarios were associated with a higher number of identified LSTs; however, the difference was not statistically significant.

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“…Several studies showed adding SBLE to ED nurses' orientation, unit competency training, and continuing education courses increased learning, nurse confidence levels with the new knowledge, and greater ED nurse satisfaction with the pedagogical method. [8][9][10][11][12] Saqe-Rockoff et al 13 use of low-fidelity simulation in a pediatric sepsis simulation resulted in increased ED nurse confidence levels ( P < .001) and adherence to Pediatric Advanced Life Support guidelines ( P < .001).…”

Section: Literature Reviewmentioning

confidence: 99%

A Clinical Nurse Specialist–Driven Project to Improve Emergency Department Triage Accuracy

et al. 2022

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The purpose of this quality improvement project was to examine the use of video-simulated scenarios and mobile technology to improve accuracy of emergency department (ED) nurses' triage using the Emergency Severity Index (ESI). Design:A quality improvement project with a pre/post educational intervention design consisting of a convenience sample (n = 33) of ED registered nurses (RNs) at a large tertiary hospital in the Midwest was used. Methods:A retrospective chart review (n = 495) was completed to obtain ESI accuracy for each triage RN. For 12 consecutive weeks, the ED RNs received different video simulations via mobile technology to determine the ESI level. After receiving their scores, the project team provided the RNs the correct ESI score with rationale via mobile technology. Post intervention, a retrospective chart review was conducted to evaluate RNs' ESI accuracy. Results:Results of this ED triage educational intervention to improve the accuracy of ED nurses' ESI scores were not significant; however, this novel approach may be considered in addition to other teaching strategies to improve outcomes. Conclusions:Triage nurses' ESI scoring accuracy can be inconsistent. Therefore, to ensure patients are receiving prompt and appropriate care for their acuity level, it is important to continuously provide education on ESI scoring.

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Low-Fidelity, In-Situ Pediatric Resuscitation Simulation Improves RN Competence and Self-Efficacy

Cited by 23 publications

References 28 publications

GENESISS 2—Generating Standards for In-Situ Simulation project: a systematic mapping review

GENESISS 2—Generating Standards for In-Situ Simulation project: a systematic mapping review

Multiprofessional perspectives on the identification of latent safety threats via in situ simulation: a prospective cohort pilot study

A Clinical Nurse Specialist–Driven Project to Improve Emergency Department Triage Accuracy

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