A Multi-Institutional Simulation Boot Camp for Pediatric Cardiac Critical Care Nurse Practitioners

被引：32

作者：

Brown, Kristen M. ^{[1
,2
,3
]}

Mudd, Shawna S. ^{[1
]}

Hunt, Elizabeth A. ^{[2
,3
]}

Perretta, Julianne S. ^{[2
,3
]}

Shilkofski, Nicole A. ^{[4
]}

Diddle, J. Wesley ^{[5
]}

Yurasek, Gregory ^{[5
]}

Bembea, Melania ^{[2
]}

Duval-Arnould, Jordan ^{[2
,3
]}

Nelson McMillan, Kristen ^{[2
]}

机构：

[1] Johns Hopkins Univ, Sch Nursing, Dept Acute & Chron Care, Baltimore, MD USA

[2] Johns Hopkins Univ, Sch Med, Dept Anesthesiol & Crit Care Med, Baltimore, MD 21205 USA

[3] Johns Hopkins Med Simulat Ctr, Baltimore, MD USA

[4] Johns Hopkins Univ, Sch Med, Dept Pediat, Baltimore, MD 21205 USA

[5] George Washington Univ, Sch Med, Dept Pediat, Washington, DC 20052 USA

来源：

PEDIATRIC CRITICAL CARE MEDICINE | 2018年 / 19卷 / 06期

基金：

美国国家卫生研究院;

关键词：

boot camp; congenital heart disease; low cardiac output; pediatric nurse practitioner; rapid cycle deliberate practice; simulation; NEAR-INFRARED SPECTROSCOPY; CONGENITAL HEART-DISEASE; HIGH-FIDELITY SIMULATION; OUTPUT SYNDROME; DELIBERATE PRACTICE; SURGERY DATABASE; OUTCOMES; QUALITY; MANAGEMENT; OPERATION;

D O I：

10.1097/PCC.0000000000001532

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Objectives: Assess the effect of a simulation boot camp on the ability of pediatric nurse practitioners to identify and treat a low cardiac output state in postoperative patients with congenital heart disease. Additionally, assess the pediatric nurse practitioners' confidence and satisfaction with simulation training. Design: Prospective pre/post interventional pilot study. Setting: University simulation center. Subjects: Thirty acute care pediatric nurse practitioners from 13 academic medical centers in North America. Interventions: We conducted an expert opinion survey to guide curriculum development. The curriculum included didactic sessions, case studies, and high-fidelity simulation, based on high-complexity cases, congenital heart disease benchmark procedures, and a mix of lesion-specific postoperative complications. To cover multiple, high-complexity cases, we implemented Rapid Cycle Deliberate Practice method of teaching for selected simulation scenarios using an expert driven checklist. Measurements and Main Results: Knowledge was assessed with a pre-/posttest format (maximum score, 100%). A paired-sample t test showed a statistically significant increase in the posttest scores (mean [sd], pre test, 36.8% [14.3%] vs post test, 56.0% [15.8%]; p < 0.001). Time to recognize and treat an acute deterioration was evaluated through the use of selected high-fidelity simulation. Median time improved overall time to task across these scenarios. There was a significant increase in the proportion of clinically time-sensitive tasks completed within 5 minutes (pre, 60% [30/50] vs post, 86% [43/50]; p = 0.003] Confidence and satisfaction were evaluated with a validated tool (Student Satisfaction and Self-Confidence in Learning). Using a five-point Likert scale, the participants reported a high level of satisfaction (4.70.30) and performance confidence (4.8 +/- 0.31) with the simulation experience. Conclusions: Although simulation boot camps have been used effectively for training physicians and educating critical care providers, this was a novel approach to educating pediatric nurse practitioners from multiple academic centers. The course improved overall knowledge, and the pediatric nurse practitioners reported satisfaction and confidence in the simulation experience.

引用

页码：564 / 571

页数：8

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