Keleekai Nowai L, Schuster Catherine A, Murray Connie L, King Mary Anne, Stahl Brian R, Labrozzi Laura J, Gallucci Susan, LeClair Matthew W, Glover Kevin R
From Nursing Administration (N.L.K.), Orientation and Education (M.A.K., L.J.L., S.G.), Overlook Medical Center, Summit, NJ; Clinical Education and Training (C.A.S., C.L.M., B.R.S., K.R.G.), Curriculum Development, Electronic, and Mobile Learning (M.W.L.), B. Braun Medical, Inc., Bethlehem, PA.
Simul Healthc. 2016 Dec;11(6):376-384. doi: 10.1097/SIH.0000000000000186.
Peripheral intravenous catheter (PIVC) insertion is one of the most common invasive procedures performed in a hospital, but most nurses receive little formal training in this area. Blended PIVC insertion training programs that incorporate deliberate simulated practice have the potential to improve clinical practice and patient care.
The study was a randomized, wait-list control group with crossover using nurses on three medical/surgical units. Baseline PIVC knowledge, confidence, and skills assessments were completed for both groups. The intervention group then received a 2-hour PIVC online course, followed by an 8-hour live training course using a synergistic mix of three simulation tools. Both groups were then reassessed. After crossover, the wait-list group received the same intervention and both groups were reassessed.
At baseline, both groups were similar for knowledge, confidence, and skills. Compared with the wait-list group, the intervention group had significantly higher scores for knowledge, confidence, and skills upon completing the training program. After crossover, the wait-list group had similarly higher scores for knowledge, confidence, and skills than the intervention group. Between the immediate preintervention and postintervention periods, the intervention group improved scores for knowledge by 31%, skills by 24%, and decreased confidence by 0.5%, whereas the wait-list group improved scores for knowledge by 28%, confidence by 16%, and skills by 15%.
Results demonstrate significant improvements in nurses' knowledge, confidence, and skills with the use of a simulation-based blended learning program for PIVC insertion. Transferability of these findings from a simulated environment into clinical practice should be further explored.
外周静脉导管(PIVC)置入是医院中最常见的侵入性操作之一,但大多数护士在这方面接受的正规培训很少。结合刻意模拟练习的混合式PIVC置入培训项目有可能改善临床实践和患者护理。
该研究是一项随机、等待列表对照组且有交叉设计的研究,研究对象为三个内科/外科科室的护士。对两组护士均进行了PIVC知识、信心和技能的基线评估。干预组随后接受了为期2小时的PIVC在线课程,接着是使用三种模拟工具的协同组合进行的为期8小时的现场培训课程。然后对两组进行重新评估。交叉之后,等待列表组接受相同的干预,两组再次接受评估。
在基线时,两组在知识、信心和技能方面相似。与等待列表组相比,干预组在完成培训项目后,知识、信心和技能得分显著更高。交叉之后,等待列表组在知识、信心和技能方面的得分同样高于干预组。在干预前和干预后的即时阶段,干预组知识得分提高了31%,技能得分提高了24%,信心得分下降了0.5%,而等待列表组知识得分提高了(此处原文有误,根据前文逻辑应为降低)28%,信心得分提高了16%,技能得分提高了15%。
结果表明,使用基于模拟的混合式学习项目进行PIVC置入培训,护士的知识、信心和技能有显著提高。应进一步探索这些研究结果从模拟环境到临床实践的可转移性。