Introduction:
University Hospitals Health System (UHHS) has seen an interest by nursing in using simulation and case studies as an adjunct to classroom education to instruct in emergency situations and mock codes. UHHS is currently expanding neuroscience services at 2 community hospitals while maintaining services at the quaternary care hospital. There is a need for further neuroscience education of both experienced nurses who have limited neuroscience exposure and novice nurses employed in neuroscience specialty areas. Patient simulators have been used in a variety of education settings, yet their effectiveness in training nurses to manage neurologic patients and neurologic emergencies has not been widely examined. The purpose of this project is to evaluate the use of high-fidelity simulation on nurses’ assessment skills, critical thinking and comfort in caring for neuroscience patients.
Methods:
A pre and post survey design was used for this project with nurses completing a survey immediately prior to and after participating in 3 simulation scenarios: intracerebral hemorrhage with intracranial pressure, subdural hematoma with seizures, and brain tumor complicated by pulmonary embolism. After completion of each scenario a debriefing occurred. Surveys allowed nurses to assess their confidence levels in responding to neurologic emergencies using a 5-point Likert-type scale (1= strongly disagree to 5 = strongly agree).
Results:
Comfort level was assessed in five different categories. Comfort in performing a neurologic assessment improved from a pre-survey average of 4.02 to a post-survey average of 4.59, a variance of 11.4%. Comfort in managing a stroke patient improved from 3.98 to 4.45, a variance of 9.5%. Comfort in administering emergency medications improved from 3.02 to 3.98, a variance of 19.1%. Comfort in identifying neurologic changes improved from 3.82 to 4.43, a variance of 12.3%. Comfort in communicating neurologic changes to the provider improved from 4.00 to 4.66, a variance of 13.2%. There was an overall improvement in the variance in all 5 categories of 13.1%.
Conclusion:
The use of high-fidelity simulation allowed nurses to gain comfort in assessment, management, and provider communication specific to neuroscience patients.
“Is there a neurologist on this flight?”
