Effectiveness of a Web-Based Simulation in Improving Nurses' Workplace Practice With Deteriorating Ward Patients: A...

Area of Science:

• Nursing Education
• Patient Safety
• Clinical Deterioration Management

Background:

• Nurses are crucial for identifying clinical deterioration, yet failures in triggering timely interventions persist despite existing patient safety initiatives like the Rapid Response System.
• A Web-based simulation was developed to enhance nurses' recognition and response to deteriorating patients, but its impact on actual clinical practice remained unevaluated.

Purpose of the Study:

• To evaluate the impact of Web-based simulation on nurses' recognition and response to deteriorating patients in clinical settings.
• To measure outcomes using Kirkpatrick's 4-level evaluation model, focusing on the rate of triggering deteriorating patient events as the primary clinical outcome.

Main Methods:

• A before-and-after study was conducted on two general hospital wards over 14 months.
• Nurses completed questionnaires assessing motivation, knowledge, and perceived learning transfer post-simulation.
• Clinical records were analyzed for the frequency and types of patient deterioration triggers 6 months before and after the intervention.

Main Results:

• The rate of deteriorating patients triggered by ward nurses significantly increased post-simulation (8.96% to 14.58%, P<.001).
• Nurses reported positive transfer of learning (mean 3.89) and motivation (mean 3.78) regarding the simulation.
• Significant improvements were observed in nurses' knowledge scores post-simulation compared to pre-simulation.

Conclusions:

• Web-based simulation is effective in enhancing nursing practice for recognizing and responding to deteriorating patients.
• This educational tool can be widely adopted by nurse educators globally to meet the needs of hospital nurses caring for deteriorating patients.