Proposed Topic (Most preferred): :
Staff Engagement and Empowerment (motivating staff / teamwork / work revamp tackling manpower issue / staff wellness / OSH / retention)
Proposed Topic (Second preferred): :
Clinical Safety and Quality Service II (Projects aiming to enhance clinical safety and outcomes, clinical governance / risk management)
Authors (including presenting author) :
LEUNG LBS(1), TSOI SC(2)(3), CHOW WY(1), WONG TY(1), TSAI MK(1), NG MS(1), WEI CY(1), (3), LAM YF(1) ,HO HS(1)(2), LUNG KC(1), LEUNG YW(2)
Affiliation :
(1)Department of Medicine, Pamela Youde Nethersole Eastern Hospital
(2)Nethersole Clinical Simulation Training Centre, Pamela Youde Nethersole Eastern Hospital
(3)Nursing Services Division, Pamela Youde Nethersole Eastern Hospital
Introduction :
Haematology nursing management can cause life-threatening conditions if prompt interventions are not provided. A patient with a central venous access catheter is susceptible to develop Central Line Associated Blood Stream Infection (CLABSI) under inappropriate nursing care.
Medical simulations facilitate learner to navigate intricate situations and understand multifaceted performance factors. A curriculum that focuses on Vascular Access Management (VAM), provides ample skill practice opportunities, and immersive scenarios. Total 17 nurse participants enrolled in the structured simulation program in 2023.
Objectives :
To enhance junior nurses managing CLABSI and life-threatening conditions through a comprehensive simulation training program in haematology nursing.
Methodology :
A training team was formed to develop training curriculum, which included domain experts in nurse specialist, infectious diseases consultant, stimulation facilitators. 2 identical VAM stations and simulation based scenarios were designed specifically for junior nurses under 3 years’ experiences.
Knowledge-Skills-Attitude (KSA) approach is being utilized to enhance nurse competence.
Knowledge (K): Dialectic lectures and discussions by nurse specialist and medical consultant on Central Line Associated Blood Stream Infection (CLABSI), immediate management of febrile neutropenia, and catheter dislodgement.
Skills (S): A video assisted skills demonstration and practice session focused on catheter access skills, exit site observations, and related complications to demonstrate appropriate nursing care and deliver deliberate feedback regarding their own skills.
Attitude (A): The importance of immediate management was being discussed in order to minimize infections and potential complications. Discussion aimed to increase learners' awareness and promote a positive attitude towards effective management to enhance patient safety.
Two immersive scenarios (1- neutropenic sepsis, 2- catheter dislodgement) simulated potentially life-threatening haematological conditions. CRM –based debriefing approach was used after scenarios.
Design:
Pre and Post-test design to assess knowledge competency, staff confidence and satisfaction.
Outcome measure:
6 points Likert scale questionnaire and VAM quiz on knowledge competence.
Result & Outcome :
Results
Paired-T test was employed for data analysis. The program improved candidates' “Awareness and recognition of CLABSI” from a mean 2.7/6 to 5.29/6, (t=11.03, p=<0.0001). “Confidence in immediate management FN” from a mean of 3.1/6 to 5.2/6, (t=12.29, p=<0.0003). Furthermore, the candidates’ vascular access management quiz scores rose from a mean of 5.67/10 to 8.17/10 (t=5.28, p=<0.0001). Overall 100% participants satisfied the program.
Qualitative feedback included: “Improve clinical reasoning on caring pathway of patients with neutropenic sepsis”, “Knowledge enhancement on CLABSI”.
Conclusion
Comprehensive scenario based simulations have a proven benefit when applied to acute medical education and should be widely available for nurse training among different specialties.
