Paper
Friday, 21 July 2006
This presentation is part of : Promoting Excellence: An Evidence-Based Practice Approach in a Children's Hospital
Using Evidence to Educate And Evaluate Effectiveness of Nursing Practice
Eva M. Stone, RN, MSc, Phoenix Children's Hospital, Phoenix, AZ, USA and Natalie Truett, BSN, Clinical Education, Phoenix Children's Hospital, Phoenix, AZ, USA.
Background: With diminishing resources, health care organizations are challenged to produce measurable outcomes of educational interventions. An opportunity was identified with the opening of a new pediatric airway unit. An evidence-based education program was developed to increase nurses’ confidence in caring for patients with critical airway issues, including patients with tracheal reconstruction, tracheostomies, macrognathia, patients who are ventilator dependent, and those who are being weaned from the ventilator. This patient population is extremely vulnerable to airway dysfunction and /or loss.  Comprehensive planning of care, and patient and family focused education is required.  A tool to evaluate the effectiveness of such education is needed.

Methods: Nurses were interviewed to gather information regarding cognitive, affective, and behavioral interventions that would increase the confidence of the nurses on the new unit.  Following a literature review, a concept analysis was completed to develop a scale to measure “confidence.” The scale contains cognitive, affective, and behavioral practice statements. Measured on a Likert scale from 1 to 5, with 5 being extremely confident and 1 being not at all confident, the pre-intervention survey and subsequent surveys were administered at pre-determined intervals to measure “confidence.” Nurses new to a pediatric airway unit were then given the scale prior to educational interventions needed for practicing on the new unit.  A longitudinal design was used to measure changes in the same subjects over a 6 month time frame. 

Results:  Preliminary results provide valuable information concerning which educational interventions yield the greatest enhancement of staff nurse confidence, most notably among educator interventions at the bedside.

Conclusions:  Using an evidence-based approach toward evaluating the effectiveness of educational interventions among in a pediatric airway unit using a confidence scale suggests that the educational content provided is effective in improving the confidence levels of nurses caring for pediatric patients with airway disease.

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