.: ORİJİNAL ARAŞTIRMA
Using High-Fidelity Simulation and Standardized Patient to Improve the Intravenous Therapy of Nursing Students: A Quasi-Experimental Study
Hemşirelik Öğrencilerinin İntravenöz Tedavi Yönetimini Geliştirmek İçin Yüksek Gerçeklikli Simülasyon ve Standartlaştırılmış Hasta Kullanımı: Yarı-Deneysel Çalışma
Turkiye Klinikleri J Nurs Sci. 2024;16(3):731-42
doi: 10.5336/nurses.2023-100820
Makale Dili: EN
Tam Metin
Ücretsiz Erişim
ABSTRACT
Objective: To compare the effects of high-fidelity simulations and standardised patients on students' knowledge and skill levels regarding intravenous (IV) therapy administration. Material and Methods: This quasi experimental study was carried out among firstyear nursing students in Türkiye. The study sample included 59 students. The participants were divided into two groups. Group 1 (high-fidelity simulation) comprised 30 students, and Group 2 (standardised patient) comprised 29 students. Pre and post-test IV drug therapy administration knowledge form and IV drug therapy administration performance checklist forms were used for data collection. Mann-Whitney U and Wilcoxon signed-rank tests were used for analyses. Results: In the standardised patient group, participants' post-test knowledge scores were significantly higher than their pre-test knowledge scores. The skill scores of the standardised patient group were significantly higher than those of the high-fidelity simulation group. Students in standardized patient group scored higher on some items of the ''opening the lid of the IV catheter, three-way tap control, closing the three-way faucet, attaching the IV drug injector to the catheter, injecting the drug, removing the injector, using washing solution and closing the lid of the catheter'' in drug administration procedure. Conclusion: The results of this study showed that the use of standardised patients was more effective in increasing students' knowledge and skills in IV drug therapy administration than high-fidelity simulation situations. In the IV drug therapy administration training, nursing instructors can use standardised patients to enable students to gain knowledge and competence.
Keywords: High-fidelity simulator; nursing education; safe medication administration; simulation; standardised patient
Objective: To compare the effects of high-fidelity simulations and standardised patients on students' knowledge and skill levels regarding intravenous (IV) therapy administration. Material and Methods: This quasi experimental study was carried out among firstyear nursing students in Türkiye. The study sample included 59 students. The participants were divided into two groups. Group 1 (high-fidelity simulation) comprised 30 students, and Group 2 (standardised patient) comprised 29 students. Pre and post-test IV drug therapy administration knowledge form and IV drug therapy administration performance checklist forms were used for data collection. Mann-Whitney U and Wilcoxon signed-rank tests were used for analyses. Results: In the standardised patient group, participants' post-test knowledge scores were significantly higher than their pre-test knowledge scores. The skill scores of the standardised patient group were significantly higher than those of the high-fidelity simulation group. Students in standardized patient group scored higher on some items of the ''opening the lid of the IV catheter, three-way tap control, closing the three-way faucet, attaching the IV drug injector to the catheter, injecting the drug, removing the injector, using washing solution and closing the lid of the catheter'' in drug administration procedure. Conclusion: The results of this study showed that the use of standardised patients was more effective in increasing students' knowledge and skills in IV drug therapy administration than high-fidelity simulation situations. In the IV drug therapy administration training, nursing instructors can use standardised patients to enable students to gain knowledge and competence.
Keywords: High-fidelity simulator; nursing education; safe medication administration; simulation; standardised patient
ÖZET
Amaç: Yüksek gerçeklikli simülasyonların ve standardize edilmiş hastaların, öğrencilerin intravenöz (İV) tedavi uygulamasına ilişkin bilgi ve beceri düzeyleri üzerindeki etkilerini karşılaştırmak. Gereç ve Yöntemler: Bu yarı-deneysel çalışma Türkiye'deki hemşirelik birinci sınıf öğrencileri arasında gerçekleştirildi. Araştırmanın örneklemini 59 öğrenci oluşturmuştur. Katılımcılar 2 gruba ayrılmıştır. Grup 1 (yüksek gerçeklikli simülasyon) 30 öğrenciden ve Grup 2 (standardize hasta) 29 öğrenciden oluşuyordu. Verilerin toplanmasında ön-son test İV ilaç tedavisi uygulama bilgi formu ve İV ilaç tedavisi uygulama performans kontrol listesi formları kullanılmıştır. Analizlerde Mann-Whitney U ve Wilcoxon işaretli sıra testleri kullanılmıştır. Bulgular: Standardize edilmiş hasta grubunda katılımcıların son test bilgi puanları, ön test bilgi puanlarına göre anlamlı düzeyde yüksekti. Standardize edilmiş hasta grubunun beceri puanları, yüksek gerçeklikli simülasyon grubundan anlamlı derecede daha yüksekti. Standardize edilmiş hasta grubundaki öğrenciler İV kateterin kapağını açma, üç yönlü musluk kontrolü, üç yollu musluğu kapatma, İV ilaç enjektörünü katetere takma, ilacı enjekte etme, enjektörü çıkarma, ilaç uygulama işleminde yıkama solüsyonu kullanma ve kateterin kapağını kapatma'' maddelerinden daha yüksek puanlar aldılar. Sonuç: Bu çalışmanın sonuçları, standardize edilmiş hasta kullanımının, öğrencilerin İV ilaç tedavisi uygulamasındaki bilgi ve becerilerini arttırmada yüksek gerçeklikli simülasyon grubuna göre daha etkili olduğunu gösterdi. İntravenöz ilaç tedavisi yönetimi eğitiminde hemşirelik eğitmenleri, öğrencilerin bilgi ve yeterlilik kazanmasını sağlamak için standardize edilmiş hastaları kullanabilir.
Anahtar Kelimeler: Yüksek gerçeklikli stimülasyon; hemşirelik eğitimi; güvenli ilaç yönetimi; stimülasyon; standardize edilmiş hasta
Amaç: Yüksek gerçeklikli simülasyonların ve standardize edilmiş hastaların, öğrencilerin intravenöz (İV) tedavi uygulamasına ilişkin bilgi ve beceri düzeyleri üzerindeki etkilerini karşılaştırmak. Gereç ve Yöntemler: Bu yarı-deneysel çalışma Türkiye'deki hemşirelik birinci sınıf öğrencileri arasında gerçekleştirildi. Araştırmanın örneklemini 59 öğrenci oluşturmuştur. Katılımcılar 2 gruba ayrılmıştır. Grup 1 (yüksek gerçeklikli simülasyon) 30 öğrenciden ve Grup 2 (standardize hasta) 29 öğrenciden oluşuyordu. Verilerin toplanmasında ön-son test İV ilaç tedavisi uygulama bilgi formu ve İV ilaç tedavisi uygulama performans kontrol listesi formları kullanılmıştır. Analizlerde Mann-Whitney U ve Wilcoxon işaretli sıra testleri kullanılmıştır. Bulgular: Standardize edilmiş hasta grubunda katılımcıların son test bilgi puanları, ön test bilgi puanlarına göre anlamlı düzeyde yüksekti. Standardize edilmiş hasta grubunun beceri puanları, yüksek gerçeklikli simülasyon grubundan anlamlı derecede daha yüksekti. Standardize edilmiş hasta grubundaki öğrenciler İV kateterin kapağını açma, üç yönlü musluk kontrolü, üç yollu musluğu kapatma, İV ilaç enjektörünü katetere takma, ilacı enjekte etme, enjektörü çıkarma, ilaç uygulama işleminde yıkama solüsyonu kullanma ve kateterin kapağını kapatma'' maddelerinden daha yüksek puanlar aldılar. Sonuç: Bu çalışmanın sonuçları, standardize edilmiş hasta kullanımının, öğrencilerin İV ilaç tedavisi uygulamasındaki bilgi ve becerilerini arttırmada yüksek gerçeklikli simülasyon grubuna göre daha etkili olduğunu gösterdi. İntravenöz ilaç tedavisi yönetimi eğitiminde hemşirelik eğitmenleri, öğrencilerin bilgi ve yeterlilik kazanmasını sağlamak için standardize edilmiş hastaları kullanabilir.
Anahtar Kelimeler: Yüksek gerçeklikli stimülasyon; hemşirelik eğitimi; güvenli ilaç yönetimi; stimülasyon; standardize edilmiş hasta
REFERANSLAR:
- Uzelli Yilmaz D, Sari D. Examining the effect of simulation-based learning on intravenous therapy administration' knowledge, performance, and clinical assessment skills of first-year nursing students. Nurse Educ Today. 2021;102:104924. [Crossref] [PubMed]
- Avraham R, Shor V, Kimhi E. The influence of simulated medication administration learning on the clinical performance of nursing students: a comparative quasi-experimental study. Nurse Educ Today. 2021;103:104947. [Crossref] [PubMed]
- De Baetselier E, Dilles T, Feyen H, Haegdorens F, Mortelmans L, Van Rompaey B. Nurses' responsibilities and tasks in pharmaceutical care: a scoping review. Nurs Open. 2022;9(6):2562-71. [Crossref] [PubMed] [PMC]
- Mula CT, Solomon V, Muula AS. The examination of nurses' adherence to the 'five rights' of antibiotic administration and factors influencing their practices: a mixed methods case study at a tertiary hospital, Malawi. Malawi Med J. 2019;31(2):126-32. [Crossref] [PubMed] [PMC]
- Edwards S, Axe S. The 10 'R's of safe multidisciplinary drug administration. Nurse Prescribing. 2015;13(8):398-406. [Crossref]
- Zaybak A, Taşkıran N, Telli S, Ergin EY, Şahin M. Hemşirelik öğrencilerinin ilaç uygulamalarına ilişkin bilgilerini yeterli bulma durumları [The opinions of nursing students regarding sufficiency of their drug administration knowledge]. Journal of Education and Research in Nursing. 2017;14(1):6-13. [Link]
- Tu HN, Shan TH, Wu YC, Shen PH, Wu TY, Lin WL, et al. Reducing Medication Errors by Adopting Automatic Dispensing Cabinets in Critical Care Units. J Med Syst. 2023;47(1):52. [Crossref] [PubMed] [PMC]
- Sakallı D, Canbolat Ö. A threat to patient safety: Medication errors, reporting of medication errors and the concerns with regard to nurses. 2023;5(2):93-100. [Crossref]
- Uslu Y, Ünver V, Kocatepe V, Karabacak Ü. Example of a simulation design in nursing education: safe chemotherapy administration. Florence Nightingale Hemsire Derg. 2019;27(3):304-13. [PubMed] [PMC]
- Tuzer H, Dinc L, Elcin M. The effects of using high-fidelity simulators and standardized patients on the thorax, lung, and cardiac examination skills of undergraduate nursing students. Nurse Educ Today. 2016;45:120-5. [Crossref] [PubMed]
- Alkhalaf AA, Wazqar DY. The effect of high-fidelity simulation technology on the competency of nursing students in managing chemotherapy extravasation in patients with cancer. J Prof Nurs. 2022;42:1-7. [Crossref] [PubMed]
- Koukourikos K, Tsaloglidou A, Kourkouta L, Papathanasiou IV, Iliadis C, Fratzana A, et al. Simulation in clinical nursing education. Acta Inform Med. 2021;29(1):15-20. [Crossref] [PubMed] [PMC]
- INACSL Standards Committee. INACSL standards of best practice: Simulation SM simulation glossary. Clinical Simulation in Nursing. 2016;12:39-47. [Crossref]
- Lioce L, Lopreiato J, Downing D, Chang TP, Robertson JM, Anderson M, et al. Agency for Healthcare Research and Quality. Healthcare Simulation Dictionary. 2nd ed. Rockville, MD: Agency for Healthcare Research and Quality; 2020. [Link]
- Jarvill M, Jenkins S, Akman O, Astroth KS, Pohl C, Jacobs PJ. Effect of simulation on nursing students' medication administration competence. Clinical Simulation Nursing. 2018;14:3-7. [Crossref]
- Choi YJ, Won MR, Yoo SY. Standardized patient experiences study on clinical performance evaluation of nursing college students' ability: a qualitative study. Nurse Educ Today. 2022;118:105437. [Crossref] [PubMed]
- Ruyak S, Wright M, Levi A. Simulation to meet curricular needs in ethics. Clinical Simulation Nursing. 2017;13(3):121-6. [Crossref]
- Basak T, Aciksoz S, Ünver V, Aslan O. Using standardized patients to improve the hygiene care skills of first-year nursing students: a randomized controlled trial. Collegian. 2019;26(1):49-54. [Crossref]
- Cohen J. Statistical power analysis. Current Directions in Psychological Science. 1992;1(3):98-101. [Crossref]
- Hassanein SMA, Tantawi HR, Sadek BN, Hendy A, Awad HA. Impact of structured simulation-based and on-job training program on nurses' competency in pediatric peripheral intravenous cannulation: children's hospital experience. Nurse Educ Today. 2021;98:104776. [Crossref] [PubMed]
- Indarwati F, Munday J, Keogh S. Nurse knowledge and confidence on peripheral intravenous catheter insertion and maintenance in pediatric patients: a multicentre cross-sectional study. J Pediatr Nurs. 2022;62:10-6. [Crossref] [PubMed]
- Takmak Ş, Fidan Ö, Arslan S, Kurban N. Hemşirelik öğrencilerine verilen intravenöz kateter beceri eğitiminde hibrit simülasyonun etkisi: pilot çalışma [The effect of hybrid simulation on intravenous catheter skill training given to nursing students: pilot study]. Journal of Izmir Katip Celebi University Faculty of Health Sciences. 2021;6(1):133-41. [Link]
- Lynn P. Intravenous infusion. 3rd ed. Taylor's Clinical Nursing Skills. Philadelphia: Wolters Kluwer Health|Lippincott Williams & Wilkins; 2011. p.143-5.
- Kiernan LC, Olsen DM. Improving clinical competency using simulation technology. Nursing. 2020;50(7):14-9. [Crossref] [PubMed] [PMC]
- van den Bos-Boon A, Hekman S, Houmes RJ, Vloet L, Gischler S, van der Starre C, et al. Effectiveness of simulation training and assessment of PICU nurses' resuscitation skills: a mixed methods study from the Netherlands. J Pediatr Nurs. 2021;59:e52-e60. [Crossref] [PubMed]
- Preston P, Leone-Sheehan D, Keys B. Nursing student perceptions of pharmacology education and safe medication administration: a qualitative research study. Nurse Educ Today. 2019;74:76-81. [Crossref] [PubMed]
- Basak T, Cerit B. Comparing two teaching methods on nursing students' ethical decision-making level. Clin Simul Nurs. 2019;29:15-23. [Crossref]
- Ross MET, Bryan JL, Thomas KL, Asghar-Ali AA, Pickens SL. Elder abuse education using standardized patient simulation in an undergraduate nursing program. J Nurs Educ. 2020;59(6):331-5. [Crossref] [PubMed]
- Guerrero JG, Tungpalan-Castro GM, Al Fergani B, Gomma NH, Hafiz AH, Pingue-Raguini M. Impact of high-fidelity and virtual simulation experiences on nurses' acquired knowledge and skills for triaging suspected COVID-19 patients. Computers & Education: X Reality. 2022:100002. [Crossref] [PMC]
- Jørgensen BE, Larsen M, Gram B. Simulation as an educational tool in acute nursing care: a controlled intervention study. Nurse Education in Practice. 2018;32:28-33. [Crossref] [PubMed]
- Kim E, Kim SS, Kim S. Effects of infection control education for nursing students using standardized patients vs. peer role-play. Int J Environ Res Public Health. 2020;18(1):107. [Crossref] [PubMed] [PMC]
- Karadağ M, Yıldırım Şişman N, Çalışkan N. Use of standardized patient in nursing education: a systematic review. Journal of Surgical Operating Room Sterilization Infection Control Nursing. 2020;1(2):12-37. [Link]
- Jinkyoung MA, Youngjin L, Jiwon K. Standardized patient simulation for more effective undergraduate nursing education: a systematic review and meta-analysis. Clinical Simulation in Nursing. 2023;74:19-37. [Crossref]
.: İşlem Listesi