Clinical Investigation Facility, David Grant USAF Medical Center, Travis AFB, CA, USA.
Worldviews Evid Based Nurs. 2021 Aug;18(4):308-310. doi: 10.1111/wvn.12519. Epub 2021 Jul 1.
Health care in deployed military environments requires robust clinical nursing skills to care for patients with traumatic injuries. Blood product administration is a critical skill in which nurses should be competent. However, in non-deployed environments, blood transfusions are performed less frequently, resulting in skill competency loss.
Our clinical inquiry focused on maintaining competency for infrequently performed nursing skills, specifically blood product administration.
A literature review and critical appraisal were executed, followed by an evidence-based practice change. A knowledge test, objective and subjective assessment, and training satisfaction evaluation were performed to measure the practice change outcomes. Both inpatient and outpatient nurses were included.
Sixteen articles were identified and appraised. The evidence recommended a blended education approach, that is, lecture plus hands-on practice. Thus, a classroom lecture and simulation scenario were put into practice with an existing computer-based training for blood administration. The nurses met knowledge test standards (≥ 90%) before and after implementation, while skill performance improved by 13% and improved self-competence scores by 7%. Nurses in outpatient settings improved performance scores by 18.4% compared to inpatient nurses, whose scores improved by 9.4%. The simulation scenario completion time decreased by 8.3 minutes post-implementation, and the training program earned a 90% satisfactory rating.
A blended education program improves clinical skill performance and enhances confidence in performing critical interventions. Blended education provides a safe learning environment for nurses to be prepared for the management of low-volume patient care emergencies.
在部署的军事环境中，医疗保健需要强大的临床护理技能，以照顾创伤伤员。输血是护士应具备的一项关键技能，但在非部署环境中，输血的频率较低，导致技能熟练程度下降。
我们的临床研究重点是保持不常执行的护理技能的能力，特别是输血。
进行了文献回顾和批判性评价，随后进行了循证实践改变。通过知识测试、客观和主观评估以及培训满意度评估来衡量实践改变的结果。包括住院和门诊护士。
确定并评价了 16 篇文章。证据建议采用混合教育方法，即讲座加实践操作。因此，在现有的计算机输血培训基础上，实施了课堂讲座和模拟场景。护士在实施前后都达到了知识测试标准（≥90%），而技能表现提高了 13%，自我能力得分提高了 7%。与住院护士相比，门诊护士的绩效得分提高了 18.4%，而住院护士的绩效得分提高了 9.4%。模拟场景完成时间减少了 8.3 分钟，培训计划获得了 90%的满意度评分。
混合教育计划提高了临床技能表现，并增强了执行关键干预措施的信心。混合教育为护士提供了一个安全的学习环境，以便为管理低容量患者护理紧急情况做好准备。
