The Henderson Repository is a free resource of the Honor Society of Nursing, Sigma Theta Tau International. It is dedicated to the dissemination of nursing research, research- related, and evidence-based nursing materials. Take credit for all your work, not just books and journal articles. To learn more, visit www.nursingrepository.org Item type Presentation Title Training Nurses for Charge Nurse Duties Through Simulation Authors Zlatkin, Igal; Peker, Haia Downloaded 15-May-2018 22:55:55 Link to item http://hdl.handle.net/10755/335171
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Training Nurses for Charge Nurse Duties through … Nurses for Charge Nurse Duties through Simulation ... Coordinator of Nursing Staff Professional Development Haya Peker - RN ...
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The Henderson Repository is a free resource of the HonorSociety of Nursing, Sigma Theta Tau International. It isdedicated to the dissemination of nursing research, research-related, and evidence-based nursing materials. Take credit for allyour work, not just books and journal articles. To learn more,visit www.nursingrepository.org
Item type Presentation
Title Training Nurses for Charge Nurse Duties ThroughSimulation
– Accurate report to shift supervisor regarding the ward
status
Each task is scored by Likert scale from 1 to 5
The total score was calculated18
Research Instrumets (cont.)
3. Script concordance test evaluating
charge nurses’ decision-making
– The test was designed by the
researchers and validated by
expert judgement
– The test consists of 6 items
describing common situations
that require fast decision making
19
Script Concordance Test• Method of assessment for clinical data
interpretation
– Examines steps used in clinical reasoning
– Case-based assessment
– “Real Life” scenarios allow uncertainty
– Same scenario for each learner
– Objective scoring instead of subjective
judgment of skilled observers
20Deschenes et al, 2011; Humbert et al, 2011
SCT Test
21
Clinical scenario
If you were thinking of…
And then you find… This hypothesis becomes…
Nursing
Hypothesis
New information -2 -1 0 +1 +2
- 2 = rejected/ contraindicated - 1 = less relevant/not very useful 0 = neither less nor more useful +1 = useful +2 = necessary
Brief description of problem/ situation
Relevant hypothesis/intervention
New information:• Change in patient conditions• Laboratory result
Learner must make a decision
Deschenes et al, 2011; Humbert et al, 2011
You're the charge nurse during night shift. At 4 AM noise was heard from room N 14. When you've entered the room, you've found the patient A.B. laying on the floor next to his bed. A.B. is confused (He has an Altzhaimer's disease) and unable to explain what happened. You’ve reported to the physician and his responce was: « If the patient is OK I'll see him at 6 AM »
If you think of… And then you find… The intervention will become...
Calling the physician to see the patient right now
Patient vital signs are within the normal range. No visible injury.
-2 -1 0 +1 +2
- 2 = rejected/ contraindicated - 1 = less relevant/not very useful 0 = neither less nor more useful +1 = useful +2 = necessary
Example Question
22
Example Question
23
You're the charge nurse during evening shift. In addition to being charge nurse, you're caring for 8 complicated patients. Your staff is experienced nurse 49 y.o. and novice nurse 27 y.o. who is pregnant (12 th week). You've got a message from ER about admission of patient suspected to measles within the next 30 minutes
If you think of… And then you find… This decision will become…
Asking the experienced nurse to take care of the patient suspected to measles
The experienced nurse refuses to take care of the patient. She doesn't remember whether she had measles in the past. The novice nurse is sure she hadn't measles.
-2 -1 0 +1 +2
- 2 = rejected/ contraindicated - 1 = less relevant/not very useful 0 = neither less nor more useful +1 = useful +2 = necessary
Scoring of SCT
Do the clinical decisions chosen by the learner have
concord with those of the “Reference Panel” ?
– A group of experienced nursing professionals/ clinical preceptors (at least 10)
– Each question score depends on the number of Reference Panel answers
0 : 8 members 1 : 7 members All other answers
8/8 = 1 point 7/8 = 0.88 point
0/15 = 0 point
Example: Scoring by 15 experts
24Deschenes et al, 2011; Humbert et al, 2011
Procedure
• Measurement of participants’ perception of the
training usefulness:
– Immediately after the training
– 6 months after commencing charge nurse duty
performance
• Measurement of charge nurses decision-
making
─ 6 months after commencing charge nurse duty
performance
25
Procedure (cont.)
• Observations of novice charge nurses’
performance of their duties:
– By 3 trained observers
– During 3rd to 4th month of performing charge nurse
duties
– Scoring by the checklists
26
Results
27
Participants’ rating immediately after trainingt-test, n=42
SigtStand.
Dev.MeanGroup
P<.013.780.494.63SimulationMeeting the
Expectations 0.514.05Control
p<.052.60.514.50SimulationDecision -
making 0.604.086 months
P<.017.430.474.68SimulationCommunication
skills 0.513.55Control
n.s.2.450.694.18SimulationAnxiety
reduction 0.453.89Control
28
Participants’ rating 6 months after trainingt-test, n=42
SigtStand.
Dev.MeanGroup
p<.00112.450.294.9SimulationMeeting the
Expectations 0.583.15Control
p<.0018.420.384.81SimulationDecision -
making 0.613.516 months
P<.0018.480.474.63SimulationCommunication
skills 0.513.35Control
n.s.4.180.594.15SimulationAnxiety
reduction 0.673.94Control
29
Participants’ rating :Decision Making Skills Training
30
4.54.8
4.05 3.5
0
1
2
3
4
5
6
Immediately After 6 months
Simulation group Control group
Decision-making scoret-test, n=42
Method of teaching Mean SD t Sig.
Script Concordance
TestScore
Simulation group
5.7 .65
2.72 p <.05Control group 4.9 1.2
31
Observation scoret-test, n=42
Method of teaching Mean SD t Sig.
Charge Nurses
Activities Check List
Score
Simulation group
18.9 3.06
2.05 p <.05Control group 17.2 2.2
32
Conclusions
Simulation in nursing staff development is an effective
training strategy to assess and strengthen the skills and
competence in nursing practice.
Simulation techniques may efficiently prepare novice nurses
to the charge nurse tasks.
Simulation training may improve the quality of performance
33
Limitations of the study• Small sample
• A non-random sample
• The tools validated by expert judgement only
• Higher frequency of charge nurse duties
performance by the simulation group members
(possible due to better performance level)
34
Developing a more detailed check list describing charge
nurse duties
Quality of shift managers' performance as a function of
their preparation, based on more frequent observation by
shift and off-shift supervisors
Further Research to be Conducted:
35
Thanks… To the clinical preceptors for participation in the
workshop:
Lena Vainshtein
Marina Feldman
Sophie Gimpelson
Alexey Dvorkin
Vicky Chernyack
Matan Offir
Gleb Dubinsky
To Mrs Tamara Keshet , Yezreel Valley College
Simulation Center manager, for assistance with the
workshop.
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