Hybrid education increases nurses’ skills in management of deteriorating patients: A QUASI-experimental study.

Abstract

Background: There is a need to develop acute care nurses’ skills in identifying and managing clinical deterioration. Aim: To evaluate the impact of a hybrid (online and simulation-based) education program on improving recognition and response to deteriorating patients. Methods: A quasi-experimental study was conducted in 2023 on two wards within a large, regional health care provider in Victoria, Australia. Thirty-nine (53.4%) participating ward nurses completed the program. Participants were surveyed before and after program participation and six to eight weeks later. Changes in evaluation scores were compared using paired T-tests. Administrative datasets were accessed to compare Medical Emergency Team call activation rates using process control charts. Findings: A total of 79 evaluation surveys were collected across the three timepoints. There was a statistically significant increase between pre- and post-intervention, in self-reported confidence for all measured indicators (p-values <.05). Large effects (d > 0.8) were found for certainty of advocating for the patient, performing a rapid assessment, performing effective airway assessment, cardiopulmonary resuscitation, and making an interprofessional plan. There was a trend for increased rates of Medical Emergency Team call escalations and a decrease in Code Blue calls over the follow-up time period. Discussion: Use of a hybrid simulation-based approach improved nurses’ knowledge and confidence to recognise and respond to deterioration, increased early escalation of care, and decreased Code Blue calls. Conclusion: This study provides preliminary evidence that the emphasis of mandatory training should change from focusing on provision of Basic Life Support to developing clinicians’ skills in detection and response to deterioration.