House of Hope: Preparing Student Nurses to Fight Infectious Disease
Background: Currently there is no confirmed case of Ebola in LA County; however, there have been many cases that reflect a rule out diagnosis. In such situations, the protocol is to restrict exposure and contact to only required personnel in those isolation areas. However, it is imperative to review with student’s isolation protocols as well as personal protective devices available and their proper use in a clinical immersion simulation. According to the CDC in 2011, there is an estimated 722,000 hospital associated infections in Acute Care Hospitals. Moreover in 2012, there were 54,500 catheter associated urinary tract infections, 30,100 central line associated bloodstream infections, 53,700 surgical site infections associated with 10 surgical procedures, and 107,700 hospital cases of clostridium difficile infections. Moreover, the overall annual direct medical costs of HAI to U.S. hospitals ranges from $28.4 to $33.8 billion. As we are faced with the Ebola Viruses in the U.S., it is important that schools of nursing serve as champions of hand hygiene and infection control campaigns so the students will serve as role models to motivate change and will take over the aging nursing workforce in the near future. A lack of institutional priority for hand hygiene and following universal precaution protocols could be a major factor in poor adherence to recommendations for hand washing.
The applications of simulation using different high fidelity simulation modalities can enhance retention in learning and improve training. Virtual simulation, mannequin simulation, and standardized patients can improve knowledge and skills. To facilitate appropriate learning during the simulation sessions, prior preparation of the participants is usually required. Preparation includes reading material and lectures, with a demonstration of what to expect during the simulation. Virtual Simulation is a unique tool in education that allows computer-aided simulation of virtual reality to introduce material and improve understanding of participants on a topic. With the use of Virtual Simulation, mannequin simulation, standardized patients, in addition to reading materials and lectures, we hope to improve our participant’s knowledge, skills and performance.
Brief description of the undertaking/best practice: Five Case Scenarios were designed with varying levels of complexity for both high fidelity and virtual simulation. Facilitators, raters, standardized patients, and mannequin operators received appropriate training on the scenarios. Participants read materials, attended lectures and received a two-hour virtual session on CliniSpace-virtual simulation with a facilitator, which served as preparation for the simulation. Debriefing followed every case scenario.
Outcomes: measures of outcomes included: pre and post simulation survey; technical skills simulation evaluation; pre and post perception survey; student self-reflection; rater evaluation; evaluation of simulation experience; and standardized patient evaluation of the participants’ simulation. Participants of the simulations have higher score in the post evaluation of knowledge, skills, and practice compared to the pre-evaluation scores.
Conclusion/Implications: The implementation of the simulation enhanced the training on infectious disease control and prevention and subsequently protecting the health care professionals and the public at large.