The Implementation of Case Based Simulation and Mastery Learning for Lumbar Puncture Training in novice Advanced Practice Providers
graduate medical education
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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
Background: Lumbar punctures (LP) are a common aspect of care for the hospitalized patient and are performed by a broad range of physician and non-physician providers. Complications of lumbar punctures increase morbidity and mortality and are strongly associated with individual skill level. Best practices in bedside procedural training are well established, however adherence to these practices is poor and variable. Purpose: This project is a quality improvement initiative aimed at identifying and implementing best practices in LP training for novice advanced practice providers (APPs) at a large academic medical center. Methods: Pubmed and Google Scholar were searched prior to October 2019, to identify features of effective bedside procedure training. These findings were used to develop a multi-phase training program for novice APPs, including evaluation using the Lumbar Puncture Assessment Tool to evaluate for mastery prior to clinical practice. Results: Each of the APPs participating in the training program successfully passed the simulation-based mastery evaluation and were able to submit for independent LP privileges after a maximum of three days of apprentice-style clinical experience training. Conclusions: Best practice in procedural training and skill building has been well established, despite variable implementation. This project revealed implementation of these best practices to be practical, effective and efficient for LP training in the hospital setting, providing support for similar interventions in other bedside procedures.
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