Implementation of a Supervised Focused Infusion Therapy Clinical Experience and Its Impact on Confidence and Competence

Abstract

The Art and Science of Infusion Nursing N urse educators are tasked by the American Association of Colleges of Nursing 1 with preparing "generalist nurses" that can care for a variety of patients across different life spans. This education and preparation includes not only theoretical knowledge but also clinical skills. 1 Patients are presenting to health care facilities with increasingly complex medical issues; as such, it is imperative that nursing students are trained to be competent in the common and basic care of a diverse group of patients. In particular, nurses must be prepared and knowledgeable about providing peripheral intravenous (PIV) care, as Rickard et al 2 state that nearly 70% of all hospitalized patients receive infusion therapy. The Institute for Safe Medication Practices states that this percentage may be as high as 90% or more. 3 As such, the literature calls for nurse educators to teach prelicensure nursing students about infusion therapy to prepare them for practice. [4][5][6][7] LITERATURE REVIEWInfusion therapy has been described in the literature as a complex 8 and skilled 7 area of nursing practice. In prelicensure education, PIV catheter (PIVC) insertion has been labeled among one of the most challenging clinical skills taught in nursing programs. 9 Despite these harrowing descriptions, nurses are expected to be able to perform infusion therapy, because it is also considered an essential or core skill. 6 , 10 , 11 Infusion therapy is often described as "the stick." However, it encompasses much more than the actual venipuncture process (obtaining vascular access or PIVC insertion). Other components of infusion therapy include: documenting and monitoring the vascular access site, 6 , 12 , 13 managing the infusion pump, infusion drug calculations, 14 PIVC medication administration, 6 , 14 and therapeutic ABSTRACT Infusion therapy is a challenging skill set, yet nursing students are expected to implement these skills in the practice environment with minimal hands-on experience. This study aimed to determine whether implementation of a supervised, focused infusion therapy clinical resulted in competence and increased confidence of undergraduate nursing students when performing infusion therapy, as well as to evaluate student perceptions of the best instructional method. The study took place in February 2020 after 5 weeks of comprehensive instruction. Participants reported increased confidence ( P < .005 ) and competence (66%) in infusion therapy following the focused clinical experience. Findings suggest that a focused clinical can facilitate confidence and competence in nursing students related to infusion therapy.