Effects of a standardized patient-based simulation in anaphylactic shock management for new graduate nurses

Abstract

Background Patients may be endangered if new graduate nurses cannot recognize and manage anaphylactic shock. Consequently, enhancing the new graduate nurses’ understanding of their roles and responsibilities during the rescue of a patient with anaphylactic shock is important. However, due to its inherent limitations, traditional classroom-based teaching makes it difficult to explore the potential of the students. Although popular simulation teaching has several notable advantages, it has not been proven to be effective in training inexperienced nurses on anaphylactic shock. We investigated the effect of a standardized patient-based simulation on the behaviors of new graduate nurses’ during anaphylactic shock rescue to identify an effective and safe method for contemporary nursing education. Methods Except for the ill or pregnant, all the new graduate nurses were included in the study as students to undergo a standardized patient-based simulation conducted in the clinical skills center of a general hospital. The simulation training was designed to teach students to recognize the signs and symptoms of anaphylactic shock, place the patient in the correct position, stop the ongoing intravenous infusion of the antibiotic which triggers the anaphylactic shock, restart an intravenous infusion on a new infusion apparatus, give 100% oxygen via a nasal cannula or mask, preserve airway patency, call the rapid response team, and correctly administer the medications prescribed by the clinicians. Before and after the training, the instructors evaluated each student’s skills and behaviors using a clinical competency evaluation list. After the training, all students completed the Chinese version of the Simulation Design Scale (SDS) to demonstrate their satisfaction with the program and then participated in semi-structured interviews with their instructors. Results All 104 graduate nurses had a significant improvement on the 6 competencies of the clinical competency evaluation list after the simulation training (P < 0.001). The SDS scores revealed that the students were highly satisfied with all the aspects of the simulation training (the 20 satisfaction rates were all above 90.00%). During the semi-structured interviews, most of the new graduate nurses reported that simulation training in the management of anaphylactic shock was critical and would guide them in clinical practice. Conclusion Simulation training in anaphylactic shock is a potentially viable and effective method for teaching new graduate nurses to manage clinical incidents.

The Outcomes of an Interprofessional Simulation Program for New Graduate Nurses

“…A major contribution of this study is an appreciation that the interprofessional simulation program should be taken into consideration for new-graduate training. The positive learning outcomes help new graduate nurses understand the required clinical healthcare policies and traditions for working with doctors, respiratory therapists, and other health care providers when managing patients with urgent care needs [ 3 , 5 , 6 ]. This study indicated that an interprofessional simulation training program can improve the clinical care ability of new graduate nurses; increase their understanding of the roles of other healthcare professionals; enhance the understanding of interprofessional teamwork; and help participants develop their understanding of teamwork.…”

“…Simulation training programs have played critical roles in realistic clinical situations, such as to increase the understanding of the responsibilities of other healthcare professionals, and to encourage interprofessional caring attitudes [ 37 , 38 ]; to enhance critical thinking [ 39 ]; to improve interprofessional communication skills [ 38 ]; to advance the recognition of patient safety [ 23 , 40 , 41 , 42 ]; and to inspire learning motivation and satisfaction [ 43 ]. In China, research on the outcomes of a standardized patient-based simulation of anaphylactic shock management for 104 new graduate nurses found significant improvement in the competencies of assessment skills and ability to place the patient in a correct position, to maintain an airway, and to administer oxygen and other therapies after the simulation training [ 6 ]. In Korea, an online simulation training program helped new graduate nurses enhance their knowledge and skills, as well as improve their confidence in patient care [ 30 ].…”

“…Interprofessional collaboration is an important core competence for nurses [ 1 ], which enhances nurses’ ability to develop teamwork in patient care and collaborative care with other healthcare professionals [ 2 , 3 , 4 ]. An important component of interprofessional education is simulation training, which helps develop professional skills and collaboration among nurses and other care givers [ 5 , 6 ]. Interprofessional simulation training also can help close the gap between academic learning and clinical nursing practice for new graduate nurses.…”

Debriefing, espaço dialógico para o desenvolvimento do pensamento reflexivo na enfermagem

“…Para apoiar o facilitador na condução do debriefing existem diferentes técnicas: Debriefing com bom julgamento (10) ; PEARS (11) ; Plus-Delta (12) ; modelo Outcome-Present-State Test (OPT) (13) ; o Gather-Analyze-Summarize (GAS) (14) , dentre outros.…”

“…O GAS corresponde a umguia que fornece uma estrutura para definir o início, o meio e a conclusão do processo. A primeira fase, representada pela letra G (gather), é para reunir informações e reações; a segunda, representada pela letra A (analyze), é para realizar a análise dos pontos destacados; e a última, representada pela letra S (summarize), para resumir o que ficou de aprendizado (14) .…”