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Screening for critical congenital heart disease in newborns using pulse oximetry: evaluation of nurses' knowledge and
Donna J Ryan1, Elizabeth Bradshaw Mikula, Sarah Germana
1Duke University School of Nursing (Drs Ryan, Silva, and Derouin) and Duke University Medical Center Birthing Center (Dr Germana), Durham, North Carolina; and HCA Henrico Docors' Hospital (Ms Mikula), Richmond, Virginia.
Insights
An online education module significantly improved nurses' knowledge and adherence to critical congenital heart disease (CCHD) screening protocols. This quality improvement initiative demonstrated enhanced documentation of pulse oximetry readings in newborns.
Area of Science:
- Neonatal care
- Nursing education
- Quality improvement
Background:
- Critical congenital heart disease (CCHD) screening using pulse oximetry is vital for early detection in newborns.
- Effective implementation relies on healthcare professionals' understanding and consistent application of screening protocols.
- Online education offers a scalable solution for disseminating evidence-based practices to nursing staff.
Purpose of the Study:
- To evaluate the benefits of an online nursing education program on CCHD screening protocols.
- To assess the impact of the education module on nurses' knowledge and adherence to CCHD screening documentation.
- To determine the effectiveness of the intervention in an academic obstetric referral center.
Main Methods:
- A repeated-measures quality improvement study design was employed.
- Registered nurses in the birthing center participated in an online education module.
- Knowledge was assessed via online tests, and documentation adherence was evaluated through medical chart reviews of 300 newborns before and after the intervention.
Main Results:
- Significant improvement in nurses' knowledge scores was observed immediately after the education module (P = .0046) and maintained at 3 months.
- Documentation of pulse oximetry reading locations significantly improved post-intervention (P < .0001 for both right hand and right foot).
- Knowledge scores showed a positive trend across baseline, immediate post-intervention, and 3-month follow-up (P = .0564).
Conclusions:
- Online education effectively enhances nurses' knowledge regarding CCHD screening protocols.
- Pre-implementation education is crucial for successful adoption of new clinical practices.
- Continuous quality improvement monitoring is recommended to sustain nursing adherence to updated protocols.
Purpose:
The purpose of this project was to evaluate the benefits of an online nursing education program addressing the significance and rationale of an evidence-based critical congenital heart disease (CCHD) screening protocol using pulse oximetry implemented on full-term newborns delivered at an academic obstetric referral center. The aim was to assess nurses' knowledge of the protocol and nurses' adherence to the protocol documentation before and after the education module was implemented.
Subjects:
Registered nurses working in the birthing center who completed the online knowledge tests and an education module.
Design:
A repeated-measures quality improvement study was conducted to assess nurses' knowledge of the evidence supporting CCHD screening by pulse oximetry and adherence to the correct documentation of the screening protocol before, immediately after, and 3 months following participation in an online education module.
Methods:
Nurses' knowledge of the CCHD screening protocol was determined by the number of correct answers on a 10-item online test administered before and after the education module. Adherence to correct documentation of the protocol before and after the education intervention was evaluated. The medical charts of 300 newborns delivered at the center with pulse oximetry readings performed after 24 hours of age and before discharge were randomly selected and reviewed.
Results:
A significant improvement in knowledge test scores was observed immediately after the education module (9.1 ± 1.0), relative to baseline (8.4 ± 1.2; paired t = 3.02, P = .0046). A significant increase in knowledge test scores measured at baseline, immediately after, and 3 months postintervention was also indicated (F = 3.25; df = 2, 24; P = .0564). Documentation of the protocol in the medical charts for the location of the readings significantly improved after the educational intervention (right hand: 28%, 83%, and 90%; right foot: 27%, 82%, and 89%; both P < .0001).
Conclusions:
Providing education to staff before implementing new practice changes enhances their knowledge. Quality improvement monitoring is recommended to ensure nursing adherence to any practice change.
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