St Vincent's Hospital, Melbourne, Education and Learning, Victoria Parade, Fitzroy, Victoria 3065, Australia; University of Melbourne, Medicine, Dentistry and Health Sciences, Australia.
St Vincent's Hospital, Melbourne, Department of Social Work, Victoria Parade, Fitzroy, Victoria 3065, Australia; University of Tasmania, Centre for Rural Health, Australia.
Nurse Educ Today. 2022 Oct;117:105460. doi: 10.1016/j.nedt.2022.105460. Epub 2022 Jul 14.
The chance of hospital staff encountering a patient with a trauma history is high. The way health services are offered and carried out are important when engaging with people who have experienced trauma. Implementing training in trauma-informed care (TIC) is part of a cultural change of benefit to both patients and staff. Simulation-based training is a well-accepted method to reduce staff fear and anxiety when working with individuals in distress and to address issues relating to bias and stigma.
To provide simulation-based TIC training to graduate nurses.
A three-phase process was undertaken to i) create the intervention, ii) determine feasibility, and iii) evaluate the developed training.
A 600-bed inner-city tertiary hospital in Melbourne, Victoria.
Graduate nurses undertaking their first year of employment (n = 23).
The content of the training was created using evidence derived from a literature review, a scoping study of available resources, and expert consensus. A pre/post-test within-groups design to assess the safety, acceptability, and effectiveness of the training was undertaken.
The Trauma Informed-Simulation Based Training (TI-SBT) aims to increase TIC knowledge and promote TIC behaviours. It is delivered face-to-face over one day and encompasses an education component followed by three immersive patient simulations using professional actors. Analysis found significant improvement in TIC knowledge (p ≤ 0.001, 95% CI = -3.53, -0.47) and behaviours (p = 0.013, 95% CI = -8.88, -5.03). No significant differences were found in measures of anxiety and confidence. Satisfaction with all aspects of the training was high. Qualitatively, participants provided concrete examples of changes to their practice to facilitate TIC.
The developed and novel TI-SBT is a feasible (safe, acceptable, and effective) way of introducing TIC to graduate nurses. These findings provide strong evidence to support a more rigorous evaluation of the training by randomised controlled trial. The TI-SBT has the capacity to not only improve patient care but the experience of hospital staff.
医院工作人员遇到有创伤史的患者的机会很高。在与经历过创伤的人交往时，提供和开展卫生服务的方式非常重要。实施创伤知情护理 (TIC) 培训是对患者和工作人员都有益的文化变革的一部分。基于模拟的培训是一种行之有效的方法，可以减少工作人员在处理痛苦中的个人时的恐惧和焦虑，并解决与偏见和耻辱相关的问题。
为毕业护士提供基于模拟的 TIC 培训。
采用三阶段的方法进行干预，确定可行性，并评估开发的培训。
维多利亚州墨尔本的一家拥有 600 张床位的市区内三级医院。
从事第一年工作的毕业护士（n=23）。
使用文献综述、现有资源的范围研究以及专家共识中得出的证据来创建培训内容。采用前后测的同组设计评估培训的安全性、可接受性和有效性。
创伤知情模拟培训 (TI-SBT) 旨在提高 TIC 知识并促进 TIC 行为。它是面对面进行的，为期一天，包括教育部分，然后是三个使用专业演员的沉浸式患者模拟。分析发现 TIC 知识（p≤0.001，95%CI=-3.53，-0.47）和行为（p=0.013，95%CI=-8.88，-5.03）有显著提高。焦虑和信心的测量没有显著差异。对培训的各个方面都非常满意。定性分析，参与者提供了他们实践中的具体例子，以促进 TIC。
开发的新颖 TI-SBT 是向毕业护士介绍 TIC 的一种可行（安全、可接受和有效的）方法。这些发现为通过随机对照试验更严格地评估培训提供了有力证据。TI-SBT 不仅可以改善患者护理，还可以改善医院工作人员的体验。
