Patient deterioration simulation experiences: impact on teaching and learning
- Authors: Buykx, Penny , Cooper, Simon J. , Kinsman, Leigh , Scholes, Julie , McConnell-Henry, Tracy , Cant, Robyn
- Date: 2012
- Type: Text , Journal article
- Relation: Collegian: Journal of the Royal College of Nursing Australia Vol. 19, no. 3 (2012), p. 125-129
- Full Text: false
- Reviewed:
- Description: Early recognition and management of patient deterioration are essential nursing skills, and can be improved through education and experience. However, both nursing students and registered nurses may have few opportunities to develop and maintain the emergency management skills necessary to ensure patient safety. Using both theory and empirical evidence, we have developed a simulation-based educational model, ‘FIRST2ACT’ (Feedback Incorporating Review and Simulation Techniques to Act on Clinical Trends), to provide nurses with a high-fidelity learning experience. The model has been tested in three different settings: it is highly acceptable to learners, adaptable to different training needs, and shows promise in improving actual clinical performance.
Developing team based acute care scenarios: a rural hospital experience
- Authors: Missen, Karen , Sparkes, Louise , Porter, Joanne , Cooper, Simon J. , McConnell-Henry, Tracy
- Date: 2013
- Type: Text , Journal article
- Relation: International Emergency Nursing Vol. 21, no. 3 (2013), p. 186-189
- Full Text: false
- Reviewed:
- Description: Background Health professionals work in teams in a variety of health care settings especially in medical emergency teams at times of crisis. However, Registered Nurses (RNs) rarely have the chance to partake in educational programs designed for teams of nurses to practice working together in life-threatening situations. Further RN’s employed in rural setting have less opportunities for professional development than their city based counterparts. Simulated scenarios with a patient actor in a rural hospital have been utilised in this study to provide nurses with the opportunity to work as a team in the early recognition and management of patients with acute medical conditions. Aim This discussion paper focuses on one aspect of a larger research project with the aim of describing the development of team based scenarios for a rural hospital setting, focusing on the detection and management of a deteriorating patient. Methods Three team based scenarios, the related assessments and feedback techniques are all described. Conclusion Team based simulation provides a unique opportunity to assist registered nurses in rural settings in re-skilling or maintaining their emergency management skills.
Family presence during resuscitation (FPDR) : A survey of emergency personnel in Victoria, Australia
- Authors: Porter, Joanne , Cooper, Simon J. , Taylor, Beverley
- Date: 2015
- Type: Text , Journal article
- Relation: Australasian Emergency Nursing Journal Vol. 18, no. 2 (2015), p. 98-105
- Full Text: false
- Reviewed:
- Description: Background: Family presence during resuscitation (FPDR) has been endorsed internationally by resuscitation councils since the year 2000; however, the extent to which FPDR is practiced in emergency settings requires further investigation. Methods: Emergency personnel ( n= 347) from 18 participating emergency departments across the state of Victoria, Australia completed a 10-page questionnaire, which was designed to develop an understanding of the current practice and implementation of FPDR and to ascertain the differences in practice between adult and paediatric resuscitations. Results: Emergency personnel update their adult and paediatric advanced life support qualifications annually with 87% of nurses and 65% of doctors completing adult life support and 72% of nurses and 49% of doctors completing paediatric advanced life support training. The majority of nursing staff reported support for FPDR (83%) with over 70% indicating that it is apart of their current practice. There was strong agreement from both nurses (79%) and doctors (77%) that the family have the right to be present. A family support person was deemed as essential by nurses (92%) and doctors (89%) when allowing family to be present. A factor analysis was conducted on participant statements, revealing four codes; impact on professional practice and performance, personnel beliefs about FPDR, professional satisfaction and the importance of a support person and saying goodbye. Conclusion: A family support person was highlighted as essential to the successful implementation of FPDR, together with the development of a comprehensive training the education program for emergency personnel. FPDR continues to be a significant issue and further investigation into FPDR practice and implementation in the ED is warranted. © 2014 College of Emergency Nursing Australasia Ltd.
Collaboration between nurses and physicians in an Indonesian Emergency Department
- Authors: Suryanto , Plummer, Virginia , Copnell, Beverley
- Date: 2016
- Type: Text , Journal article
- Relation: Australasian Emergency Nursing Journal Vol. 19, no. 2 (2016), p. 82-89
- Full Text: false
- Reviewed:
- Description: Background: Positive collaboration between nurses and physicians is essential in emergency practice because it has a significant relationship with the quality, safety, accountability, and responsibility of care. The aim of this study was to examine nurses' and physicians' attitudes towards collaboration in the Emergency Department in the Indonesian context. Methods: The study was a comparative study using a modified Jefferson Scale of Attitude towards Physician-Nurse Collaboration. Data were collected from 47 nurses and 24 physicians of one of 25 general hospitals in Malang, Indonesia, by anonymous survey. Results: Emergency nurses had significantly more positive attitudes towards collaboration than emergency physicians (P < 0.001). Emergency nurses had significantly higher scores in three of four domains of the instrument, "physician dominance", "nurse autonomy", and "caring as opposed to curing". The effects of gender, age, and education on nurses' and physicians' attitude towards collaboration were not statistically significant. However, experience in the Emergency Department of the general hospital was significantly related to participants' attitudes towards collaboration (P = 0.023). Conclusions: The findings of this study indicate that attitudes towards collaboration among the two professions should be enhanced. Inter-professional education and promotion of teamwork may be solutions to improve the relationship, not only between nurses and physicians, but also other healthcare providers. © 2016 College of Emergency Nursing Australasia.
Designing a medical records review tool: An instructional guide
- Authors: McConnell-Henry, Tracy , Cooper, Simon J. , Endacott, Ruth , Porter, Joanne , Missen, Karen , Sparkes, Louise
- Date: 2015
- Type: Text , Journal article
- Relation: Contemporary Nurse Vol. 50, no. 1 (2015), p. 72-79
- Full Text: false
- Reviewed:
- Description: Background: Medical Records Reviews (MRR) are commonly used in research and quality activities in health care, however, there is a paucity of literature offering a step by step guide to devising a reliable, user-friendly tool. Aim: This instructional paper focuses on the stages used to design and implement successful MRR using examples from two reviews in Australian rural hospitals investigating the responses of Registered Nurses to patient deterioration, and guided by time series principals. Methods: The MRR were conducted in two rural hospitals in conjunction with a simulation learning intervention where nurses rehearsed clinical management of a deteriorating patient. A six-step template is presented to guide practitioners on how to design and use a MRR tool. Conclusion: When well-planned and appropriately used, MRR provides an excellent means for examining patient outcomes in addition to safety and quality of care.
The influence of anxiety on student nurse performance in a simulated clinical setting : A mixed methods design
- Authors: Al-Ghareeb, Amal , McKenna, Lisa , Cooper, Simon J.
- Date: 2019
- Type: Text , Journal article
- Relation: International Journal of Nursing Studies Vol. 98, no. (2019), p. 57-66
- Full Text: false
- Reviewed:
- Description: Background: Anxiety has a powerful impact on learning due to activation of anxiety hormones, which target related receptors in the working memory. Experiential learning requires some degree of challenge and anxiety. Patient simulation, as a form of experiential learning, has been an integrated component of health professional education internationally over the last two decades, especially in undergraduate nursing education. Little information is available to determine if and how anxiety impacts nursing students’ clinical performance during simulation. Objectives: To investigate physiological and psychological anxiety during emergency scenarios in high-fidelity simulation and understand the effect of anxiety on clinical performance. Design: First2Act was the model for the simulation intervention. Second and third year undergraduate nursing students attended a two-hour simulation session and completed a demographic questionnaire plus pre-simulation self-reported psychological anxiety scale. A heart rate variability monitor was attached to each student's chest to measure heart rate variability (as a sign of anxiety) before engaging in two video-recorded simulated emergency scenarios (cardiac and respiratory) with a professional actor playing the patient. Performance was rated by a clinician followed by video-assisted debriefing. Finally, heart monitors were removed and students repeated self-reports of psychological anxiety. Results: Students’ psychological anxiety was high pre-simulation and remained high post-simulation. With regard to physiological anxiety, students were anxious at the start of the simulation but became more relaxed toward the end as they gained familiarly with the simulation environment (p < .007). Clinical performance increased significantly in the second scenario (p < .001). Factors found to positively affect clinical performance were length of enrolment in the nursing degree (p = .001), current employment in a nursing or allied healthcare field (p = .030), and previous emergency experience (p = .047). The relationship between physiological anxiety and clinical performance was statistically not significant, although there was an indication that low level anxiety led to optimal performance. Conclusion: High-fidelity patient simulation has the capacity to arouse novice nurses psychologically and physiologically while managing emergency situations. Indicative outcomes suggest that optimal performance was apparent when anxiety levels were low, indicating that they had received insufficient training to deal with situations that induced moderate to high anxiety levels.
Compassion satisfaction and compassion fatigue in Australian emergency nurses : a descriptive cross-sectional study
- Authors: O'Callaghan, Erin , Lam, Louisa , Cant, Robyn , Moss, Cheryle
- Date: 2020
- Type: Text , Journal article
- Relation: International Emergency Nursing Vol. 48, no. (Jan 2020), p. 8
- Full Text:
- Reviewed:
- Description: Introduction: Emergency nurses are at risk of compassion fatigue. Compassion fatigue caused by exposure to suffering may compromise the individual's personal wellbeing and reduce work efficiency. Methods: A quantitative cross-sectional survey with open responses was conducted using the Professional Quality of Life: Compassion Satisfaction and Compassion Fatigue (ProQOL) scale and open-ended questions. Responses from a convenience sample of 86 nurses from two hospital emergency departments in Victoria, Australia, were analysed. Results: The median score for Compassion Satisfaction was 78% with all nurses reporting average to high scores. Most had average levels of Compassion Fatigue: Burnout median score was 53% and Secondary Traumatic Stress median score 49%. No statistically significant correlation was found between scales nor with influencing demographic characteristics. A qualification in emergency nursing was predictive of Compassion Satisfaction. Six descriptive job-associated factors contributed to nurses' stress: human resources, the organisation, job-specific components, patient mix and professional and personal components. Conclusion/s: Average to high levels of Compassion Satisfaction and low to average levels of Compassion Fatigue were found in emergency nurses. Issues contributing to stress were work and role related. An understanding of these stressors may help nurses and nurse managers to ameliorate emergency nurses' levels of stress and help limit staff burnout.
The TEAM instrument for measuring emergency team performance: validation of the Swedish version at two emergency departments
- Authors: Karlgren, Klas , Dahlström, Anders , Birkestam, Anderz , Norling, Annelie , Forss, Gustav , Cooper, Simon J.
- Date: 2021
- Type: Text , Journal article
- Relation: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine Vol. 29, no. 1 (2021), p.
- Full Text:
- Reviewed:
- Description: Background: The Team Emergency Assessment Measure (TEAM) questionnaire is designed for rating the non-technical performance of emergency medical teams during emergencies, e.g., resuscitation or trauma management. Originally developed in Australia it has today been translated and validated into eleven languages, but a Swedish version is lacking. The aim was therefore to cross-culturally translate and evaluate the reliability and validity of the TEAM questionnaire in a Swedish health care setting. Methods: The instrument was forward and backward translated and adapted into a Swedish context according to established guidelines for cross-cultural adaptation of survey-based measures. The translated version was tested through 78 pairwise assessments of 39 high-priority codes at the emergency departments of two major hospitals. The raters observed the teams at work in real time and filled in the questionnaires immediately afterwards independently of each other. Psychometric properties of the instrument were evaluated. Results: The original instrument was translated by pairs of translators independently of each other and reviewed by an expert committee of researchers, nurses and physicians from different specialties, a linguist and one of the original developers of the tool. A few adaptations were needed for the Swedish context. A principal component factor analysis confirmed a single ‘teamwork’ construct in line with the original instrument. The Swedish version showed excellent reliability with a Cronbach’s alpha of 0.955 and a mean inter-item correlation of 0.691. The mean item-scale correlation of 0.82 indicated high internal consistency reliability. Inter-rater reliability was measured by intraclass correlation and was 0.74 for the global score indicating good reliability. Individual items ranged between 0.52 and 0.88. No floor effects but ceiling effects were noted. Finally, teams displaying clear closed-loop communication had higher TEAM scores than teams with less clear communication. Conclusions: Real time observations of authentic, high priority cases at two emergency departments show that the Swedish version of the TEAM instrument has good psychometric properties for evaluating team performance. The TEAM instrument is thus a welcome tool for assessing non-technical skills of emergency medical teams. © 2021, The Author(s). **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Simon Cooper" is provided in this record**