The effectiveness of high fidelity simulation on medical-surgical registered nurses' ability to recognise and respond to clinical emergencies.

BACKGROUND: There is a paucity of evidence regarding the efficacy in preparing medical-surgical nurses to respond to patients with acutely deteriorating conditions.

STUDY AIM: The aim of this study was to evaluate registered nurses' ability to respond to the deteriorating patient in clinical practise following training using immersive simulation and use of a high fidelity simulator.

METHODS: This study was a follow-up survey of medical-surgical graduate nurses following immersive high fidelity simulation training. Thirty eight registered nurses practising in medical-surgical areas completed the simulation as part of university graduate study. A follow-up survey of the graduate medical-surgical registered nurses conducted three months following completion of a high fidelity simulation-based learning experience. Outcomes consisted of the number of times skills were used in practise and the usefulness of simulation in preparing for actual emergency events.

RESULTS: Participants reported a total of 164 clinical patient emergencies in the follow-up time period including: 46% cardiac, 32% respiratory, 10% neurological, 7% cardiac arrest and 5% related to electrolyte disturbances. The ability to respond in a systematic way, handover to the emergency team and airway management were identified as the skills most improved during patient emergencies following simulation. The most useful aspects of the simulation experience identified were scenario debriefing and assertiveness training. Participants with less years of clinical experience were more likely to report practising the team leader role and debriefing as the most useful aspects of simulation.

CONCLUSIONS: The skills practised in simulation were highly relevant to participants practise in medical-surgical areas. Non-technical skills, including assertiveness skills should be considered in future emergency training courses for nurses.