Quality improvement for self-confidence, critical-thinking, and psychomotor skills in basic life support of nursing health professionals through case-scenario simulation training

Abstract

Background: Recognition and timely management of medical emergencies in non-critical care units are essential in initiating and delivering high quality care. Simulation training is a constructive tool that can be utilized to refresh and maintain knowledge and skills for staff that may not encounter medical emergencies frequently. This study examined staff that work at the John D. Dingell VA Medical Center Community Living Center (CLC), a subacute and inpatient rehabilitation unit, on their critical thinking skills, knowledge, role responsibilities and confidence levels prior to and after implementation of a mixed intervention of a one-hour webinar didactic and one-hour case-based simulation with debriefing. The purpose of the study was to improve non-critical care staff critical thinking, knowledge and confidence when working with a deteriorating patient.Methods: A pretest-posttest study design was used to conduct the study. Pre and post surveys were given to 42 health professionals which included registered nurses (RN), licensed practical nurses (LPN) and nursing aides after participating in a case scenario using a high-fidelity mannequin to simulate a medical emergency. Analyses were performed using the two-tailed t-test with p-value significance of less than .05 using Excel and JMP by SAS.Results: Among the 42 participants, there was a significant improvement in confidence for recognizing signs of patient deterioration for timely activation of code team (p < .001). Critical thinking skills and knowledge on appropriate activation of the type of response team based on patients’ speed of deterioration also improved after the intervention (p < .001). Overall, the staff felt more comfortable, confident and knowledgeable concerning their roles and local policy of emergent situations.Conclusions: A team-based case scenario simulation course may improve non-critical care nursing staff confidence, knowledge and critical thinking as it pertains to activation of code teams and willingness to actively participate in medical emergencies.

Enriching nursing knowledge and practice in Jordanian government hospitals through basic life support simulation training: A randomized controlled trial

“…Simulation in BLS training played a crucial role in participants’ knowledge and practice development, and the training became more dynamic among participants; surprisingly, simulation in BLS training doubled participants’ knowledge score from 5.25 in the pretest to 9.79 in the posttest-1 in addition to increasing participants’ practice level, inspiring a remarkable improvement in BLS among participants. The current study’s positive research findings on knowledge and practice scores agree with similar previous studies that used simulation in BLS training (Kose et al, 2019 ; Lee et al, 2021 ; Oermann & Gaberson, 2016 ; Umuhoza et al, 2021 ).…”

“…The second level, “know-how,” relies on the facilitator, who teaches BLS practice using simulation and shows the learners how to perform CPR. BLS facilitators should have AHA certifications (Abelsson et al, 2020 ; Etlidawati & Milinia, 2021 ; Greif et al, 2021 ; Lee et al, 2021 ) and have enough experience in intensive care units, expertise in education, training, and communication skills (Greif et al, 2021 ). The higher education level of the facilitator is the easiest way for the learners to understand the BLS.…”

“…BLS retention is the ability to recall knowledge and apply practice effectively during CPR (Lee et al, 2021 ). In the current study, the second follow-up three months after the interventions was considered beneficial for furthering evidence and understanding the worth of the simulation in BLS training as an efficient educational method to improve knowledge and practice among nurses.…”

“…Simulation training (ST) has become a vital teaching methodology in nursing education to refine nurses’ knowledge and practice (Al Gharibi & Arulappan, 2020 ; Ekert et al, 2021 ; Handeland et al, 2021 ; Higgins et al, 2020 ; Kose et al, 2019 ; Kuehnel et al, 2021 ; Lee et al, 2021 ). The endless BLS training and high-quality CPR training using simulation have a direct proportion with victims’ survival and patient outcomes (Binkhorst et al, 2021 ; Isa et al, 2022 ; Laco & Stuart, 2022 ; Oermann & Gaberson, 2016 ; Schroeder et al, 2023 ; Zhou et al, 2020 ) and a reverse relationship with unwanted outcomes (Laco & Stuart, 2022 ).…”

“…Simulation plays a vital role in learning and helps learners acquire knowledge (Park & Lee, 2021 ). It is important for BLS learning to include practical training in addition to theoretical education (Lee et al, 2021 ; Rente et al, 2021 ).…”