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Using a Serious Game to Teach Central Line Care in Pediatric Critical Care Nursing
Mouhammad Yabrodi1, Kamal Abulebda, Kellie J Pearson
1Mouhammad Yabrodi, Kamal Abulebda, and Riad Lutfi are associate professors and physicians at the Indiana University School of Medicine and Riley Hospital for Children, IU Health, Indianapolis, IN, where Mara E. Nitu is a professor and chief medical officer and Colin M. Rogerson is an assistant professor and physician. Kellie J. Pearson is a critical care respiratory therapist at IU Health, Indianapolis, IN, and Tracy Spitzer is a clinical nurse specialist at Riley Hospital for Children, IU Health, Indianapolis, IN. Nathanael Thomas Tavares is chief executive officer at Flyover Zone, Indianapolis, IN. Contact author: Mouhammad Yabrodi, myabrodi@iu.edu. The authors have disclosed no potential conflicts of interest, financial or otherwise.
Background:
Central venous catheters (CVCs) are used in pediatric patients to deliver IV fluids, blood products, medications, and nutrients. Potential complications include central line infection, which carries a high risk of morbidity and mortality in this population. Pediatric critical care nurses play a crucial role in helping to reduce the risk of infection.
Purpose:
The aim of this study was to develop, implement, and evaluate the effectiveness of a serious, simulated, gaming-based intervention to improve the skills and knowledge of RNs in the early stages of their career regarding central line insertion, care, and infection prevention.
Methods:
A single-arm, pre- and postinterventional pilot study was conducted at the Riley Hospital for Children at Indiana University Health, from July 2021 to July 2022. The study participants were bedside pediatric critical care nurses who were provided with education and skills training regarding CVC placement and maintenance through a so-called serious game-essentially, a video game with a purpose. A simulation session and multiple-choice knowledge test were used to assess skills and knowledge retention both before and after the intervention.
Results:
A total of 32 pediatric critical care nurses participated in the study; however, 1 nurse did not complete the follow-up assessment. The study revealed a statistically significant increase in the overall mean (SD) global performance score from 4.06 (2.11) before the intervention to 5.97 (1.80) afterward. Specific areas of performance also showed significant improvement: handwashing prior to the procedure (P = 0.04), covering the procedure site (P = 0.01), cleaning the site properly (P < 0.01), and ensuring central line placement before use (P < 0.01). However, there was no statistically significant difference in the nurses' performance on the multiple-choice knowledge test before and after the intervention.
Conclusion:
This study suggests that serious games have the potential to improve nursing education, particularly in complex procedures like central line insertion and maintenance. Our findings indicate that serious gaming is effective in engaging learners and enhancing their skills. More research is needed to evaluate the long-term impact of serious games on learning outcomes and patient care.
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