Background: The urinary tract is the most common site of a nosocomial infection, and roughly 600,000 hospitalized patients are affected by catheter-associated urinary tract infections (CAUTI) each year (Zurmehly, 2018). Instrumentation of the urinary tract is a precipitating cause of hospital-acquired CAUTIs resulting in more than 13,000 deaths annually, and with an estimated cost of over $340 million (Zurmehly, 2018; Ferguson, 2018). According to Cason, Atz and Horton (2017) performing urinary catheter insertion and care is an example of a procedural skill required prior to graduation.
Methods: A pretest-posttest design using the CSES and a convenience sample of first semester senior baccalaureate nursing students participated in an intervention of skills training in the simulation laboratory, with the use of iPad technology for video recording pretest-posttest. The recordings were reviewed for breaches in aseptic technique. The participants were issued their own urinary catheter kits. To ensure standardization in the skill, the catheter kits had a Q-R code, which when scanned, took students to the skills video on inserting a urinary catheter. Another Q-R code informed students of open laboratory hours (Shustack, 2018).
Participants: Data were available for 21 first semester senior baccalaureate nursing students whose age ranged from 20 to 52 years (mean, 24.3). Three participants (14%) were male and 18 (86%) were female.
Results: Findings indicated that the simulation laboratory, deliberate practice, and video debriefing, were effective in improving student’s self-efficacy in performance of nursing skills including urinary catheter insertion. Thirteen students (62%) increased their ratings by 1 or more between pretest and posttest with a p-value = 0.025. Examination of the video recorded data showed a common breach of aseptic technique was continuing to hold the catheter with the clean hand and inflate the balloon with the sterile hand. An area of greatest improvement was opening the catheter kit without contamination (100%) for the posttest recording.
Conclusion: Students self-report of self-efficacy improved, in all areas of the CSES with the exception of inserting a nasogastric tube with correct placement after the intervention. Using simulation technology in student education improves knowledge and skills with an opportunity to transfer theory to practice (Alanazi, Nicholson, & Thomas, 2017). Findings indicated, the simulation laboratory, deliberate practice, Q-R code technology, and video debriefing, were effective for improving student’s self-efficacy in performance of nursing skills. This study aimed to improve skills acquisition, specifically urinary catheter insertion by nursing students, with the goal of reducing medical error rates and improving patient care.