Advertisement

Improving Pediatric Nurses' Knowledge, Accuracy, and Confidence Through Code Documentation Simulation

Published:April 19, 2017DOI:https://doi.org/10.1016/j.ecns.2017.02.003

      Highlights

      • Simulation increases pediatric nurses' accuracy in code documentation.
      • Simulation increases pediatric nurses' knowledge in code documentation.
      • Pediatric nurses' confidence in code documentation increased after simulation.

      Abstract

      Background

      Simulation is a successful method to enhance learning, especially how to handle infrequent high-risk events, such as patient codes. However, no studies were found that examined methods for educating nurses in code documentation. The purpose of this study was to evaluate the impact of simulation on nurses' knowledge, confidence, and accuracy of code documentation.

      Methods

      A one-group pre- and posttest quasi-experimental design was used. Nurses completed a knowledge test and confidence survey before and after participating in two code simulations. Accuracy in documenting the simulated code events was also evaluated. The impact of the simulations on code documentation knowledge pre- and postsession and on the accuracy of code documentation for the two simulations per session was determined by paired-sample t-test and the impact on confidence pre- and postsession was determined by Wilcoxon signed-rank test.

      Results

      Forty-eight pediatric acute care nurses from three units participated in nine simulation sessions. There was a statistically significant increase in knowledge test scores from presimulation (M = 3.45, SD = 1.46) to postsimulation (M = 5.68, SD = 0.73) (t[47] = 9.47, p < .001 [one tailed]). Documentation accuracy improved from the first simulation (M = 4.59, SD = 1.63) to the second simulation (M = 6.36, SD = 1.66) (t[43] = 8.33, p < .001). A statistically significant increase in confidence was found following participation in the simulation session (z = –6.206, p < .0001) with a large effect size (r = 0.64). The median confidence level also increased from presimulation (Mdn = a little confident) to postsimulation (Mdn = somewhat confident).

      Conclusion

      Simulation can be used to increase nurses' knowledge, confidence, and accuracy with code documentation.

      Key words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Clinical Simulation In Nursing
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Delac K.
        • Blazier D.
        • Daniel L.
        • N-Wilfong D.
        Five alive: Using mock code simulation to improve responder performance during the first 5 minutes of a code.
        Critical Care Nursing Quarterly. 2013; 36: 244-250https://doi.org/10.1097/CNQ.0b013e3182846f1a
        • Dowson A.
        • Russ S.
        • Sevdalis N.
        • Cooper M.
        • De Munter C.
        How in situ simulation affects paediatric nurses' clinical confidence.
        British Journal of Nursing. 2013; 22: 610-617
        • Frisch A.
        • Reynolds J.
        • Condle J.
        • Gruen D.
        • Callaway C.
        Documentation discrepancies of time-dependent critical events in out of hospital cardiac arrest.
        Resuscitation. 2014; 85: 1111-1114https://doi.org/10.1016/j.resuscitation.2014.05.002
        • Levett-Jones T.
        • Lapkin S.
        A systemic review of the effectiveness of simulation debriefing in health professional education.
        Nurse Education Today. 2014; 34: e58-e63https://doi.org/10.1016/j.nedt.2013.09.020
        • Nguyen T.
        • Fox N.S.
        • Friedman Jr., F.
        • Sandler R.
        • Rebarer A.
        The sequential effect of computerized delivery charting and simulation training on shoulder dystocia documentation.
        Journal of Maternal-Fetal and Neonatal Medicine. 2011; 24: 1357-1361https://doi.org/10.3109/14767058.2010.551151
        • Painter L.M.
        • Dudjak L.A.
        • Kidwell K.M.
        • Simmons R.L.
        • Kidwell R.P.
        The nurse's role in the causation of compensable injury.
        Journal of Nursing Care Quality. 2011; 26: 311-319
        • Schiak S.M.
        • Plant J.
        • Diane S.
        • Tsang L.
        • O'Sullivan P.
        Interprofessional team training in pediatric resuscitation: A low-cost, in situ simulation program that enhances self-efficacy among participants.
        Clinical Pediatrics. 2011; 50: 807-815https://doi.org/10.1177/0009922811405518
        • Sullivan N.
        • Duval-Arnould J.
        • Twilley M.
        • Smith S.
        • Aksamit D.
        • Boone-Guercio P.
        • Hunt E.
        Simulation exercise to improve retention of cardiopulmonary resuscitation for in-hospital cardiac arrests: A randomized controlled trial.
        Resuscitation. 2015; 86: 6-13https://doi.org/10.1016/j.resuscitation.2014.10.021
        • Weaver A.
        High-fidelity patient simulation in nursing education: An integrative review.
        Nursing Education Perspectives. 2011; 32: 37-40https://doi.org/10.5480/1536-5026-32.1.37
        • Whitcomb J.
        • Seawright J.
        • Wadsworth R.
        • Flehan A.
        • Duncan E.
        • Easler G.
        • Echols L.
        A retrospective study evaluating response time and survival from a cardiopulmonary arrest.
        Dimensions of Critical Care Nursing. 2012; 32: 50-53https://doi.org/10.1097/DCC.obo13e3182768399
        • Wright W.
        • Everett F.
        Using simulation to aid student's documentation.
        Nursing Times. 2015; 111: 18-19