The Effectiveness of Simulation on Recognizing and Managing Clinical Deterioration: Meta-Analyses

Orique, Sabrina B.; Phillips, Lorraine J.

doi:10.1177/0193945917697224

Cited by 30 publications

(38 citation statements)

References 49 publications

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“…Further, the results of this review indicate that simulation‐based training for acute care nurses improves all categories of self‐report, direct observation, and clinical patient safety outcomes. These findings are consistent with conclusions from a meta‐analysis of simulation studies for clinical deterioration that included undergraduate nursing students in the academic setting by Orique and Phillips (). Despite emerging evidence from research studies about simulation training, the field is largely still based upon best practice guidelines, expert opinion, quality improvement projects, and research with undergraduate nursing students in the academic setting.…”

Section: Discussionsupporting

confidence: 90%

Does Simulation Training for Acute Care Nurses Improve Patient Safety Outcomes: A Systematic Review to Inform Evidence‐Based Practice

Lewis

Ricks

Rowin

et al. 2019

Worldviews Ev Based Nurs

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Background: Simulation is increasingly used as a training tool for acute care medical-surgical nurses to improve patient safety outcomes. A synthesis of the evidence is needed to describe the characteristics of research studies about acute care nurse simulation trainings and patient safety. An additional purpose is to examine the effects of acute care registered nurse (RN) simulation trainings on patient safety outcomes.Methods: Five Internet databases were searched for articles published on any date through October 2018 examining the effect of RN simulation trainings on patient safety outcomes in the adult acute care setting.Sample: N = 12 articles represented 844 RNs of varying experience levels and 271 interprofessional participants.Results: Nine studies (75%) used high-fidelity scenarios developed locally about high risk but infrequent events. Five studies (42%) incorporated interdisciplinary team members in the scenarios and/or outcome evaluations. Outcome measures were self-reported, direct observation, or clinical indicators. All studies in this review achieved improved patient safety outcomes. It is unknown how outcomes vary for different groups of RNs because of insufficient gender, ethnicity/race, and age reporting.Linking Evidence to Action: Findings support the design of simulation training research studies for patient safety outcomes and use of simulation training and research in acute care RNs. Additional high-quality research is needed to support this field. Future studies should include descriptors that characterize the sample (i.e., age, gender, education level, type of nursing degree, ethnicity or race, or years of experience); incorporate interdisciplinary teams; evaluate a combination of outcome measure types (i.e., self-report, direct observation, and clinical outcomes) both proximal and distal to the simulation; and that utilize standardized scenarios, validated outcome measure instruments, and standardized debriefing tools.Additional supporting information may be found in the online version of this article at the publisher's web site: Figure S1. A proposed model of simulation based training for patient safety outcomes in acute care nursing. Table S1. Characteristics of studies evaluating simulation based training for RNs and patient safety outcomes.

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Section: Discussionsupporting

confidence: 90%

Does Simulation Training for Acute Care Nurses Improve Patient Safety Outcomes: A Systematic Review to Inform Evidence‐Based Practice

Lewis

Ricks

Rowin

et al. 2019

Worldviews Ev Based Nurs

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“…In this study, supportive and diverse ways of learning provided a chance for achieving objectives/information and problem-solving while teaching concepts using problem identification, logic of argument, synthesis and problem-solving in assessing, planning and intervening in the DKA patient care scenario that are difficult to integrate and learn effectively on an acute and critical care setting. There was a significant improvement in knowledge and self-confidence in the post-test as compared to the pre-test 16,17 and a more extended period of knowledge retention and self-confidence credited to repeated simulation teaching 18 (Orique and Phillips, 2018). In this study, HFS reproduced an actual clinical scenario and promoted critical thinking through interpretation, analysis and inference and to clinical practice.…”

Section: Discussionmentioning

confidence: 63%

Testing a diabetes keotacidosis simulation in critical care nursing: A randomized control trial

D’Souza

Labrague

Karkada

et al. 2020

Clinical Epidemiology and Global Health

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Background: Integrating high fidelity simulation while teaching diabetes ketoacidosis would ensure a controlled therapeutic milieu for nursing students to practice. Purpose: To evaluate the effectiveness of simulation teaching intervention for diabetes ketoacidosis in critical care nursing for undergraduate students' in a public university. Methods: A simple, two-arm (parallel) randomized controlled trial was conducted in a national public university. A total of 164 nursing students were recruited and randomly assigned to two groups. The simulation group (N = 82) participated in the diabetes ketoacidosis high-fidelity simulation teaching intervention compared to the control group (N = 82) who were exposed to patient assignments on a clinical day on an acute medical unit. The primary outcomes were assessed using the Student Satisfaction and Self Confidence in Learning, Simulation Design Scale, Educational Practice Questionnaire, Critical Thinking Skills Tool and California Critical Thinking Skill Test from 2015 to 2016. Results: The students in the randomized control trial have had significantly higher scores on Student Satisfaction, and Self Confidence in Learning, Simulation Design, Educational Practice, Critical thinking skills and Critical Thinking Skill post-test mean scores. Younger age groups who had higher satisfaction had better selfconfidence and a positive perception of the simulation design and education practice, which reflected better learning outcomes in the simulation group compared to the control group. Conclusions: This study supports the use of high-fidelity simulation scenarios as a teaching-learning strategy that is useful for students to assess, plan, intervene and evaluate in emergencies like diabetes ketoacidosis.

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“…[57,67] Moreover, a recent meta-analysis affirms the findings in this systematic review for simulation having a positive effect as a continuing education strategy with RNs, improving both knowledge and performance outcomes. [68] On a basic level, simulation is the interactive technique for enhancing the reaction of participants to a high risk skill. [64] It can be a substitution for the real thing, such as using a manikin or a human being for simulating a healthcare scenario.…”

Section: Figure 2 Illustration Of Commonalities and Distinguishing Fmentioning

confidence: 99%

Effective patient safety education for novice RNs: A systematic review

Niemeyer¹

2017

JNEP

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Background and objective: The need is great for identifying effective evidence-based strategies that focus on increasing novice RN confidence for the application of skills used to care for patients safely. The purpose of this systematic review is to explore effective continuing education strategies that target novice RNs' professional development, enhance clinical confidence, and focus on patient safety. Results: This systematic review identified 12 articles that describe effective training strategies aimed at improving novice RNs' clinical practice confidence and skill. A thematic analysis of the data was used to systematically gain knowledge about strategies used to educate novice RNs working in the hospital setting. The majority of strategies employed a number of different types of simulation and reported varying degrees of success for improving novice RN ability to care for patients safely. Simulation, virtual reality, preceptored clinical experiences, and interdisciplinary experiences were found to be effective education strategies enhancing novice RN's skill for providing safe care. Didactic instruction had positive results, but was not as effective as simulation for novice RNs learning safe patient care. Finally, written instruction was not as effective as simulation, and hard copy supplements provided no added value to novice RNs learning safe patient care. Conclusions: Findings from this review are foundational to address calls from the Institute of Medicine (IOM) and the National League for Nursing (NLN) to reform and support post-graduate nursing education. The development of novel education and training targeting novice RNs in the hospital setting is essential, but more research is needed to enhance safe patient care.

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The Effectiveness of Simulation on Recognizing and Managing Clinical Deterioration: Meta-Analyses

Cited by 30 publications

References 49 publications

Does Simulation Training for Acute Care Nurses Improve Patient Safety Outcomes: A Systematic Review to Inform Evidence‐Based Practice

Does Simulation Training for Acute Care Nurses Improve Patient Safety Outcomes: A Systematic Review to Inform Evidence‐Based Practice

Testing a diabetes keotacidosis simulation in critical care nursing: A randomized control trial

Effective patient safety education for novice RNs: A systematic review

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