Authors (including presenting author) :
Mak MY(1), CHOI YF(2), LEUNG YWN(2), TSOI SC(2), YEUNG PH (2), HUNG L(2), TSUI C(2), PO Y(1), KNG C(1)
Affiliation :
(1) Community Healthcare Services, Hong Kong East Cluster, (2) Nethersole Clinical Simulation Training Centre, Pamela Youde Nethersole Eastern Hospital
Introduction :
With the increase in aging population and chronic diseases nowadays, the increase in patients with severe frailty and complex needs pose challenges to community nurses who provide care in a lone working environment. Simulation training has been shown to improve nurse knowledge and confidence but limited studies have been found exploring the impact on community nurses and whether simulation learning correlated with better clinical outcomes. To improve patient and staff safety, the ability of applying learning experience to practice is crucial, especially in an unfamiliar community setting.
Objectives :
The purpose of this study was to evaluate the learning experience among a staff mix of community nurses on standardized-patient (SP) simulation and to examine the sustainability of learning in improving clinical outcomes.
Methodology :
A pre- and post-analytic repeated-measures design was adopted from the year of 2015 to 2019 to evaluate (i) learning experience using surveys completed by participants immediately after simulation and (ii) whether the learning improved clinical outcomes after 12 and 24 months of intervention by examining the quality improvement data (the ability to identify clinical near miss and the presence of clinical incidents). Participants were recruited from the nursing staff of Community Healthcare Services. Demographic data was compared using descriptive statistics and Chi-squared test (for trend). Kruskal-Wallis analysis of variance (ANOVA) was used to examine group differences with post hoc analysis. McNemar test was used to analyze the statistical difference of quality improvement data between pre- and post-12 and 24 months intervention.
Result & Outcome :
Data from all 75 participants were included in the analysis. No significant differences were observed across 7 classes on demographics, nurse satisfaction (H=6.153, p= .19), and confidence change in practice (H=9.010, p= .06), but a significant improve in fidelity was noted (H = 14.443, p= .01). Qualitative comments reflected that nurses were highly satisfied with the simulated experience. The examination of the learning retention on improving clinical outcomes between pre- and post-12 and 24 months intervention evidenced a statistically significant improvement (p < .05). Conclusion: SP simulation using scenarios with careful need assessment can engage community nurses on critical thinking of various medical conditions of patients, resulting in enhanced learning experience and clinical outcomes. This study design provides a presentation of the community nursing population. Suggestions for future studies include comparing the correlation of learning retention and clinical outcomes from simulation in various nursing programs to make findings more generalizable. Further efforts on developing valid and reliable tools to measure learning experience of simulation are recommended.
