Nursing Rehearsal Simulations for Acute and Critical Care

Linda Oakley^*
*Correspondence: Linda Oakley, Department of Health Science, University of Wisconsin Madison, USA, Email:

Keywords

Critical care • Self-reflection • Learning satisfaction

Introduction

The utilization of medical attendant specialists (NPs) and doctor aides (PAs) in the ICU is a laid out model of care for giving consideration to intense and fundamentally sick patients. Aggregately named progressed practice suppliers (APPs), the combination of NPs and PAs as a component of the clinical group in intense, developing, and concentrated care has developed fundamentally, due to some extent to expanding quantities of mind boggling care patients, changing work hour limitations of clinical occupants, and expanding accessibility of APP specialists. Since the first acknowledgment of the job of APPs in the administration of basically sick patients by the Leap Frog Group in 2000 when proposals for ICU doctor staffing were determined, their rules have kept on distinguishing APPs as a recognized supplier in basic consideration. Furthermore, various labour force records have distinguished that coordinating APPs is one answer for addressing staffing needs in the ICU [1].

Broadly, of the 270,000 NPs, more than 20,000 are ensured as grown-up or paediatric intense consideration suppliers with 28% working in medical clinic settings, 5.8% working in crisis division (ED) or dire consideration settings, and 12% working in basic consideration. Of the 123,000 PAs broadly, practically 38.5% report that an emergency clinic is their essential work on setting, and late gauges are that 1.4% (1,371) work in basic consideration. Albeit the APP job is perceived in numerous nations, no information exists on the particular number rehearsing globally. Data on models of care that coordinate NPs and PAs in intense and basic consideration settings and their results of care is fundamental to enough arrangement ideal labour force techniques to address the issues of intense and basically sick patients [2].

A proof based audit distributed in 2008 recognized that of 145 articles connected with the utilization of APPs, the larger part centred around job improvement, schooling and preparing, extent of training, and job extension. Around then, 31 investigations (and no methodical surveys) were accessible which had investigated different parts of coordinating APPs into ICU and intense consideration groups to help with patient consideration the executives, build up training rules, instruct patients, families and ICU staff; and help with examination and quality improvement drives [3].

To assess the adjustment of kind of APP models of care and the effect of these jobs in the ICU and intense consideration settings in the beyond 10 years, a succinct writing survey was directed of studies distributed from January 2008 to December 2018. Acute care and critical care are among the most challenging tasks in nursing, which requires information, knowledge, and skills across multiple areas. Scenario simulations can teach nursing students how to respond to these challenges in a safe environment, which can also reduce the stress of acute and critical care prior to exposure to a clinical setting. However, few studies have examined whether scenario simulations of acute and critical care can improve the abilities of nursing students [4,5].

The experience provided by scenario simulations was guided by the best practice standards of the International Nursing Association for Clinical Simulation and Learning, which recommends outcome measures include a change in knowledge, skills, and attitudes. Students completed three selfassessment instruments before and after completion of the course: simulation learning effectiveness, self-reflection and insight, and satisfaction with the simulation format. Comparisons of pre-test and post-test scores on the selfassessment instruments evaluated the effects of the simulation learning.

Post-test scores for subscale of self-regulation for simulation learning effectiveness and insight were significantly higher compared with pre-test scores (t = −2.85, p < 0.01 and t = −5.23, p < 0.001, respectively). There was also a significant increase for learning satisfaction in post-test, compared with pre-test (t = −3.70, p < 0.001). The use of scenario simulations for teaching acute and critical care nursing improved self-regulation, insight and learning satisfaction for undergraduate nursing students.

Conclusion

Simulation is increasingly being used to prepare and supplement clinical practice in critical care areas for undergraduate Bachelor of Nursing (BN) students, with some success. However, the effects of multiple, medium– highfidelity simulations for this purpose have not been previously assessed. The purpose of this study was to assess self-reported confidence and competence using scenario-based simulations. A pre-test post-test design was used to evaluate a series of simulations conducted over a semester. There were twenty seven scenarios, incorporating programmed mannequins, moorage and actors. The scenarios were embedded in a team-based process involving preparation and video-recordings used for debriefing. Third year BN students reported their confidence and competence before and after the simulation series and made comments on their perception of the experience. Multiple scenario simulations are effective in improving BN students’ confidence and competences related to critical care practice and are an enjoyable experience for students.

Conflict of Interest

None.

References

1. Thompson, David S., Kathy O'Leary, Eva Jensen and Shannon Scott‐Findlay, et al. "The relationship between busyness and research utilization: it is about time." J Clin Nurs 17 (2008): 539-548.

Google Scholar, Crossref, Indexed at

2. Yadav, B. L. and G. M. Fealy. "Irish psychiatric nurses' self‐reported barriers, facilitators and skills for developing evidence‐based practice." J Psychiatr Ment Health Nurs 19 (2012): 116-122.

Google Scholar, Crossref, Indexed at

3. McVicar, Andrew. "Scoping the common antecedents of job stress and job satisfaction for nurses (2000–2013) using the job demands–resources model of stress." J Nurs Manag 24 (2016): E112-E136.

 Google Scholar, Crossref, Indexed at

4. Laker, C., Rose D., Clare Flach and Csipke E., et al. "Views of the Therapeutic Environment (VOTE): stakeholder involvement in measuring staff perceptions of acute in-patient care." Int J Nurs Stud 49 (2012): 1403-1410

Google Scholar, Crossref, Indexed at

5. Brennan, G., Flood C. and Bowers L. "Constraints and blocks to change and improvement on acute psychiatric wards–lessons from the City Nurses project." J Psychiatr Ment Health Nurs 13 (2006): 475-482.

Google Scholar, Crossref