Simulation as a Unit-Based Strategy to Prepare Nurses for Practice
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Publisher:The Ohio State University
Series/Report no.:The Ohio State University. College of Nursing Doctor of Nursing Practice Final Document Projects
The purpose of this evidence-based quality improvement project is to improve the orientation and onboarding process, as well as self-perceived competence, of new nurses on a pediatric cardiac-renal acute care unit by using simulation as an evidence-based approach to develop nurse competence and improve patient outcomes. The guiding framework is Benner’s Theory examining individual performance as it progresses from novice to expert with improvements based on prior exposure leading to experience, learned knowledge and intuition. Simulation allows for repeated exposure on which experience is built and requires demonstration of learned knowledge and intuitive action with the provision for discussion and reflection. The impact of the addition of simulations focused on Peritoneal Dialysis and Cardiac Dysrhythmias into unit-based orientation was measured with de-identified aggregate data and analyzed with descriptive statistics in the form of aggregate mean scores for both the Nurse Competence Scale (NCS) and Knowledge Tests. The intervention of adding high fidelity simulation to unit-based education demonstrated a positive impact on self-perceived competence, knowledge attainment and knowledge retention for the new nurse hires. The NCS competency scores showed an overall increase over time, as the participants engaged in more simulations and experienced increasing complexity of clinical patient care. In the future, the project can be replicated with larger numbers of new nurse hires and encompass their first year of practice rather than just the orientation period. Future considerations include correlating the data to patient satisfaction data and quality outcome benchmarks as well as utilizing NCS data in 360 performance evaluations.
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