Turkiye Klinikleri Journal of Nursing Sciences

.: ORIGINAL RESEARCH
The Effect of Training Given to Nurses with Algorithm-Guided In-Situ Simulation on Preventing Pressure Ulcers: An Interventional Study
Hemşirelere Algoritma Rehberliğinde Yerinde Simülasyon ile Verilen Eğitimin Basınç Yarasını Önlemeye Etkisi: Müdahale Çalışması
Tuba YILMAZERa, Hilal TÜZERa, Bahar İNKAYAa, Ayşegül ERCİYASb
aDepartment of Nursing, Ankara Yıldırım Beyazıt University Faculty of Health Sciences, Ankara, Türkiye
bAnkara City Hospital, Ankara, Türkiye
Turkiye Klinikleri J Nurs Sci. 2022;14(1):11-9
doi: 10.5336/nurses.2021-82541
Article Language: EN
Full Text
ABSTRACT
 Objective: The aim of this study was to determine the effect of training given to nurses with algorithm-guided in-situ simulation on preventing pressure ulcers. Material and Methods: This was an intervention study. The study was conducted at a university hospital's orthopedia and traumatology clinic with 21 beds. The study sample consisted of 10 post-licensure nurses and 79 pre-simulation and 84 postsimulation patients over 18 years of age, who had stayed in the clinic for at least 24 h. In the collection of data, 3 forms (the demographic data form, the information assessment form, the skill assessment form) were administered to the post-licensure nurses and 3 forms (the demographic data, the Braden scale, the follow-up form) were administered to the patients. The study consisted of 3 stages. In the first stage (01.04.2018-30.06.2018), the nurses recorded the demographic characteristics, nursing interventions for pressure ulcer prevention, pressure ulcer risks, and pressure ulcer incidence data of the patients. In the second stage, nurses participated in a scenario-based standardized patient simulation at the clinic where they worked. In the third stage (01.07.2018-30.09.2018), the nurses recorded the demographic characteristics, nursing interventions for pressure ulcer prevention, pressure ulcer risks, and pressure ulcer incidence data of the patients. The nursing interventions during this period were guided by the algorithm. Incidences of pressure ulcers for 3 months before and 3 months after the simulation were compared at the end of the study. Results: Nurses' knowledge, performance, and care interventions significantly improved during the 3 months simulation (p<0.05). Incidences of Stage 1 pressure ulcers per 1,000 patient days were 8.51 and 4.73 during the 3 months before and the 3 months after simulation, respectively (p=0.136). Conclusion: In-situ simulation is a method to reduce the incidence of pressure ulcers.

Keywords: Simulation training in nursing; algorithms; pressure ulcer; prevention
ÖZET
 Amaç: Bu araştırma, hemşirelere algoritma rehberliğinde yerinde simülasyon ile verilen eğitimin basınç yarasını önlemeye etkisinin değerlendirilmesi amacıyla yapılmıştır. Gereç ve Yöntemler: Araştırma müdahale çalışması olup, bir üniversite hastanesinin 21 yataklı ortopedi ve travmatoloji kliniğinde gerçekleştirilmiştir. Çalışmanın örneklem grubunu 10 hemşire ve 18 yaşından büyük en az 24 saat klinikte kalan simülasyon uygulaması öncesi dönemde 79 hasta, simülasyon uygulaması sonrası dönemde ise 84 hasta oluşturmuştur. Verilerin toplanmasında hemşirelere 3 farklı form (demografik veri formu, bilgi değerlendirme formu, beceri değerlendirme formu) uygulanmıştır ve hastalara 3 farklı form (demografik veri formu, Braden basınç yarası risk değerlendirme ölçeği, basınç yarası önleme takip formu) uygulanmıştır. Araştırma, 3 aşamada gerçekleştirilmiştir. Birinci aşamada (01.04.2018-30.06.2018), çalışmanın yapıldığı klinikte bulunan hastaların demografik özellikleri, basınç yarasının önlenmesine ilişkin yapılan hemşirelik uygulamaları, hastaların basınç yarası riskleri ve basınç yarası insidans verileri hemşireler tarafından kayıt edilmiştir. İkinci aşamada, hemşireler çalıştıkları klinikte senaryo eşliğinde standart hasta simülasyonuna katılmıştır. Üçüncü aşamada (01.07.2018-30.09.2018), hemşireler tarafından hastaların demografik özellikleri, basınç yarasının önlenmesine ilişkin yapılan hemşirelik uygulamaları, hastaların basınç yarası riskleri ve basınç yarası insidans verileri hemşireler tarafından kayıt edilmiştir. Bu dönemde hemşirelik uygulamaları algoritma rehberliğinde yapılmıştır. Çalışma sonunda, simülasyon uygulamasından önceki ve sonraki 3 aylık dönemler arasındaki basınç yarası insidansları karşılaştırılmıştır. Bulgular: Hemşirelerin bilgi, performans ve bakım uygulamaları simülasyon uygulamasından sonraki 3 aylık dönemde anlamlı olarak yükselmiştir (p<0,05). Simülasyon uygulamasından önceki ve sonraki dönemler arası Evre 1 basınç yarası insidans hızı 1.000 hasta-günü için sırasıyla 8,51 ve 4,73 olarak belirlenmiştir (p=0,136). Sonuç: Yerinde simülasyonun basınç yarası insidans oranlarını azaltan bir yöntem olduğu görülmektedir.

Anahtar Kelimeler: Hemşirelikte simülasyon eğitimi; algoritma; basınç yarası; önleme
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