Evaluation of simulation training for nursing anaphylaxis protocol: a pilot study.

Abstract

Introduction: The Ballarat Health Services (BHS) Hospital in the Home (HitH) nursing staff have been using an anaphylaxis protocol for over 12 months. These staff independently attend home visits for the administration of medications & other treatments. It is important that they are familiar with the BHS anaphylaxis protocol. Due to the low frequency of anaphylaxis, it is difficult to maintain staff skills. We evaluate the efficacy of different training methods. Specifically we look at high fidelity simulation training compared with traditional training. High fidelity simulations have become popular for the education of health professionals. Given they are resource intensive efficacy must be assessed.

Aims: Evaluate simulation training for the BHS anaphylaxis protocol. Compare simulation with traditional methods. Develop and verify an assessment tool to achieve these.

Methods: Nine HitH nursing staff attended a training session on the BHS anaphylaxis protocol. They either attended a high fidelity simulation (n = 6) or a traditional training session (n = 3). These were conducted at Ballarat Base Hospital. A three-part survey was designed: • modified Likert scale to assess confidence. • True/false and multiple-choice questions to assess declarative knowledge. • protocol ordering and picture matching questions to assess procedural knowledge. Participants completed this survey both prior to and at least one week after their training session.

Results: The mean score before the training session was 48.88 (SD 6.04), compared with a mean score of 60.22 (SD 7.87) after the training session. A Welch Two Sample t-test demonstrated a statistically significant increase following the training (t = 3.561, p = 0.003, CI 4.7-18.8). The mean difference in participants who attended the high fidelity simulation session was 12.8, compared with 9.7 for those attending traditional training. A Welch Two Sample t-test did not demonstrate a statistical significance for this difference of means (t = 0.825, p=0.437, CI -5.9-12.2). Power was insufficient to confirm the statistical significance of these findings.

Conclusion: The BHS Anaphylaxis protocol is a critical clinical skill. The large change in mean survey score with training demonstrated poor baseline knowledge of this protocol, indicating a need for ongoing training. We have shown training increases knowledge of the protocol. The trend indicates that high fidelity simulation training is more effective. The successful validation of the assessment tool will allow follow-up studies.