Journal
JOURNAL OF CLINICAL NURSING
Volume 26, Issue 23-24, Pages 4848-4856Publisher
WILEY
DOI: 10.1111/jocn.13955
Keywords
clinical deterioration; clinical performance; education; nurses' role; rapid response systems; simulation; vital signs measurement; web-based learning
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Funding
- National University of Singapore - Yong Loo Lin School of Medicine
- Alice Lee Centre for Nursing Studies
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Aims and objectivesTo evaluate the effectiveness of a Web-based educational program to enhance enrolled nurses' knowledge and skills in the recognition and management of deteriorating patients. BackgroundWard nurses of different skill levels play a pivotal role in detecting and responding to deteriorating patients. A skill mix of registered nurses, enrolled nurses, licensed practical nurses or healthcare assistants is often employed for the provision of nursing care in acute settings. Non-registered nurses frequently perform bedside care and are in the best position to detect deteriorating patientsand initiate immediate actions, including commanding the attention of registered nurses. Education is needed to improve the knowledge and skills of these nurses. DesignA randomised controlled trial with a pretest-post-test design. MethodsThe sample included enrolled nurses from an acute care tertiary hospital. Following a baseline evaluation, the experimental group received a Web-based educational intervention. Pre-post assessment of skills and knowledge was performed with a simulated scenario and a knowledge questionnaire. Sixty-four nurses completed the entire study. ResultsFollowing the intervention, participants from the experimental group were significantly more likely than those in the control group to monitor the patient's respiratory and pulse rates. In addition, they had significantly higher post-test mean scores for knowledge and skills in assessing and managing clinical deterioration and reporting deterioration. ConclusionThe Web-based educational intervention significantly improved enrolled nurses' knowledge and skills in the recognition and management of a deteriorating patient in a simulated setting. Relevance to clinical practiceEase of access to the Web-based platform contributed to the feasibility and acceptability of this study, which has the potential to positively impact patient safety.
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