An Interprofessional Web-Based Approach to Critical Care Education: Development and Financial Impact

The purpose of this project was to create a web site to be used for the online clinical orientation and continuing education of nurses in three specialized critical care units in a non-profit community hospital. Review of the previous educational model identified the need for additional evidence-based content. The former face-to-face orientation classes and supplemental online courses were time consuming and expensive. In addition, revision of the program was needed to address the various levels of experience of nurses starting to work in the units: experienced critical care nurses, experienced non-critical care nurses and graduate nurses.  The team also identified the need to provide an opportunity for periodic remediation of educational content for nurses currently working in the units.

To begin, the interprofessional team was assembled consisting of a Clinical Nurse Specialist Consultant, Critical Care Educator, Cardiothoracic Clinical Nurse Specialist, Respiratory Therapist and Information Technology Specialist. A survey was completed by the management team and staff to identify priorities to be included in course content. A prototype of the prospective website was created. Administrative approval to purchase a unit-specific portal was obtained in order to establish a secure website. The unit-specific portal allowed off-site access by the management team and staff. The range of capabilities of the existing learning management system (LMS) was reviewed for compatibility with the new web site. Testing capabilities of the LMS allowed for the creation and application of post-tests to accompany each module. Results of scores from the post-tests identified problem areas that needed to be addressed with each newly hired nurse. The team conducted a review of current educational content. Each team member was asked to compose learning modules that focused upon their specific areas of expertise. Evidence-based unit policies and procedures were included in the creation of each module. Upon completion of the modules, the Information Technology Specialist supervised team members in providing narration for each module before posting them to the website. All newly hired nurses were required to complete a pre-hire online assessment which assessed (1) clinical competence, (2) personality and attitude, (3) interpersonal skills and (4) critical thinking. The management team reviewed each assessment prior to the beginning of orientation to determine content areas that may need specific remediation prior to and during working in the units.

A review of the potential financial impact of the changes was significant. The previous educational model required face-to-face classes in addition to a licensing fee for supplemental online courses. The licensing fee cost $2,000.00 per year. With the previous model, the cost for each orientee to complete the online program was approximately $2,140.00 (60 hours)-$3,400.00 (100 hours) per person depending upon the length of time necessary to complete all courses. In 2011, 15 people completed orientation resulting in an approximate cost of $32,000.000.The average number of clinical hours spent with a preceptor ranged from 320-640 hours at an average of $16,254.00 per person. The orientation of only 3 graduate nurses resulted in a cost of $48,762.00. The website will result in substantial cost savings over time.

This project promoted collaboration through interprofessional review of content for the development of a critical care web site. The financial savings was substantial. The modules enhance continuing education for nurses currently working in the units by providing access to content review. In the future, capabilities to monitor yearly clinical competencies and results will be recorded on the website. Verification of professional certifications, required for all critical care nurses, will be maintained on the site providing ease of access for the management team. This individualized web-based approach to critical care education promotes quality and safety for critically ill patients by promoting a consistent standard of nursing education for new and experienced critical care nurses.