Highlights
- •PICU nurses’ skills in managing low-frequency, high-impact eventscan be supplemented with high-fidelity simulation.
- •Nurses’ self-confidence in managing pediatric resuscitation was most improved after completion of the simulation education .
- •Regular simulation education can boost knowledge, teamwork skills, and confidence between required resuscitation training.
Abstract
Purpose
The purpose of this quality improvement project was to implement an educational intervention
involving High-Fidelity Simulation (HFS) with deliberate practice for low-frequency,
high-impact events in a Pediatric Intensive Care Unit (PICU), with the goal of improving
nurses' crisis management skills.
Design and methods
Four interprofessional simulation education sessions with scenarios were created for
this project. A list of knowledge and skills points was used to guide debriefings.
All scenarios were based on low-frequency, high-impact events that required the use
of Pediatric Advanced Life Support algorithms. Participants included 24 PICU nurses
with less than two years of nursing experience. Knowledge and confidence were measured
at three timepoints: pre-simulation, one-week post-simulation, and one-month post-simulation
series. Clinical teamwork performance was measured twice, during the first and second
scenario of each simulation session.
Results
Scores for knowledge, confidence, and clinical teamwork performance improved from
pre- to post-simulation, with confidence scores showing the largest increase.
Conclusions
Regular simulation training with deliberate practice can improve PICU nurses' knowledge,
clinical teamwork skills, and confidence when managing low-frequency, high-impact
events.
Practice implications
Regular in-situ simulation training with deliberate practice can improve nursing comfort
with managing high-impact, low-frequency events in the PICU. This could lead to improved
management of actual events, especially for novice nurses with less than one year
of PICU experience.
Keywords
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References
- Methods of identifying and managing the difficult airway in the pediatric population.AANA Journal. 2015; 83 (Retrieved from): 35-41
- Chameides L. Samson R.A. Schexnayder S.M. Hazinski M.F. Pediatric advanced life support provider manual. American Heart Association, Dallas2012
- Managing deteriorating patients: Registered nurses' performance in a simulated setting.Open Nursing Journal. 2011; 5: 120-126https://doi.org/10.1016/j.nedt.2011.03.006
- Deliberate practice and the acquisition and maintenance of expert performance in medicine and related domains.Academic Medicine. 2004; 79: 70-81
- The emerging role of simulation education to achieve patient safety translating deliberate practice and debriefing to save lives.Pediatric Clinics of NA. 2012; 59: 1329-1340https://doi.org/10.1016/j.pcl.2012.09.004
- Team deliberate practice in medicine and related domains: A consideration of the issues.Advances in Health Science Education. 2017; 22: 209-220https://doi.org/10.1007/s10459-016-9696-3
- Psychometric properties of the clinical decision-making self-confidence scale.Journal of Nursing Measurement. 2014; 22 (Retrieved from): 312-322
- Pediatric resident resuscitation skills improve after “Rapid Cycle Deliberate Practice” training.Resuscitation. 2014; 85: 945-951https://doi.org/10.1016/j.resuscitation.2014.02.025
- Features and uses of high-fidelity medical simulations that lead to effective learning: A BEME q systematic review.Medical Teacher. 2005; 27: 10-28https://doi.org/10.1080/01421590500046924
- Practice facilitation handbook.(Retrieved from)Agency for Healthcare Research and Qualityhttps://www.ahrq.gov/ncepcr/tools/pf-handbook/index.htmlDate: 2013
- The role of simulation in teaching pediatric resuscitation: Current perspectives.Advances in Medical Education and Practice. 2015; 6: 239-248https://doi.org/10.2147/AMEP.S64178
- The mayo high performance teamwork scale: Reliability and validity for evaluating key crew resource management skills.Journal of the Society for Simulation in Healthcare. 2007; 2: 4-10https://doi.org/10.1097/SIH.0b013e31802b68ee
- Report of findings from the effect of high-fidelity simulation on nursing students' knowledge and performance: A pilot study (research brief vol. 40).Author, Chicago, IL2009
- Standard instruction versus simulation: Educating registered nurses in the early recognition of patient deterioration in paediatric critical care.Nurse Education Today. 2016; 36: 287-292https://doi.org/10.1016/j.nedt.2015.07.021
- Simulation education.Clinical Nurse Specialist. 2015; 29: 166-173https://doi.org/10.1097/NUR.0000000000000123
- Regular in-situ simulation training of paediatric Medical Emergency Team leads to sustained improvements in hospital response to deteriorating patients, improved outcomes in intensive care and financial savings.Resuscitation. 2017; 115: 61-67https://doi.org/10.1016/j.resuscitation.2017.03.031
- Teaching paediatric ward teams to recognise and manage the deteriorating child.Nursing in Critical Care. 2014; 19: 196-203https://doi.org/10.1111/nicc.12050
- Improving nursing communication skills in an intensive care unit using simulation and nursing crew resource management strategies.Journal of Nursing Care Quality. 2017; 32: 331-339https://doi.org/10.1097/NCQ.0000000000000241
Article info
Publication history
Published online: June 13, 2020
Accepted:
May 27,
2020
Received in revised form:
May 27,
2020
Received:
July 20,
2019
Footnotes
☆This QI project has been formally evaluated using a QI checklist and determined not to be human subjects research.
☆☆This QI project did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.