Effectiveness of High-Fidelity Patient Simulations on Nurses' Early Identification of Deteriorating Pediatric Patients, and on Patient Outcomes

Monday, 18 November 2013: 2:05 PM

Melanie G. Martin, RN MS1
Nancy Ryan-Wenger, PhD, RN, FAAN2
Leah A. Keller, RN3
Carol J Risch, RN MSN4
Terri L Long, RN, MSN1
(1)Education, Nationwide Childrens Hospital, Columbus, OH
(2)Nationwide Children's Hospital, Columbus, OH
(3)Quality Improvement Clincal Coordinator, Nationwide Children's, Columbus, OH
(4)Infectious Diseases, Nationwide Children's Hospital, Columbus, OH

Learning Objective 1: The learner will be able to identify how high fidelity simulations improve a nurse’s ability to recognize deterioration in pediatric patients and improve patient outcomes.

Learning Objective 2: The learner will be able to describe the relationships among critical thinking ability, experience with deteriorating pediatric patients, simulation experiences, and years of nursing experience

Deterioration of pediatric patients often goes unrecognized, leading to a respiratory or cardiopulmonary arrest (Code Blue).

The purpose of this study is to determine the effect of the “Cues of Deterioration Course” and pediatric high-fidelity pediatric simulations improve the accuracy of nurse’s clinical judgments and improve patient outcomes.

Subject Population: All 67 nurses on the pediatric medicine unit at our 400-bed free-standing pediatric hospital will participate.

Research Design: The design is a longitudinal, quasi-experimental clinical intervention in which subjects serve as their own controls.

Instruments: Health Sciences Reasoning Test (HSRT), Pediatric Early Warning Score (PEWS), Simulation Effectiveness Tool (SET), Leadership Evaluation Tool (LET), Nurses Self-Evaluation of Confidence and Competence in the Management of Deteriorating Patients (NSECC), Simulation Experience Questionnaire (SEQ), Nursing Demographic Form, Chart Audit Form

Procedure: October 2012: Demographics, SEQ, HSRT November 2012: Intervention “Cues of Deterioration” course (2 pediatric simulation experiences), SET, NSECC, LET. December 2012 and January 2013: 4 pediatric simulation experiences and SET. November 2012 thru October 2013 Data Collection: Chart Audit of 12 hours prior to each rapid response and code blue event to evaluate accuracy of PEWS, appropriateness of activation, if code blue was rapid response preventable, PICU transfer and survival to discharge.