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Bridging Theory and Nursing Practice in the Management of Patients on Percutaneous Ventricular Assist Device Through
Brian Fung Ming Lau1,2, Tammy Sin Kwan Ma1, Kit Yu Lau1
1Department of Adult Intensive Care, Queen Mary Hospital, Hong Kong SAR, China.
Background:
Simulation-based training has emerged as a promising strategy to enhance clinical competence in managing complex devices like percutaneous ventricular assist device (pVAD), addressing a critical gap between theoretical knowledge and practical nursing proficiency.
Objectives:
This study aims to examine whether simulation-based training improves nurses' knowledge and self-efficacy in managing the pVAD.
Methods:
A mixed-methods pilot study was conducted in a tertiary hospital in Hong Kong involving 27 critical care nurses. Participants engaged in high-fidelity simulation scenarios focused on emergency pVAD management. Quantitative measures include pre-month, immediate post-month, and 3-month follow-up assessments of pVAD knowledge and self-efficacy (Self-efficacy Scale relating to pVAD management, SES-Impella). Qualitative data from semi-structured focus group interviews explored participants' learning experiences, perceptions, and recommendations for training improvement.
Results:
Median knowledge scores increased from 11 (Interquartile range [IQR]: 9 to 14) at baseline to 14 (IQR: 14 to 15) immediately post-training (P < .001) and were maintained at 14 (IQR: 12 to 15) at 3 months (P = .015 vs. baseline). Median SES-Impella self-efficacy scores increased from 21 (IQR: 18 to 26) at baseline to 30 (IQR: 30 to 32) immediately post-training (P < .001). Qualitative findings revealed that participants valued structured debriefing, realistic scenarios, and opportunities for hands-on practice, and reported enhanced confidence in troubleshooting alarms in managing real pVAD cases.
Discussion:
Simulation-based training seems to be an effective and feasible approach to strengthening nurses' knowledge and self-efficacy in pVAD management and to supporting standardized team-based care. Future research should investigate optimal refresher intervals and explore direct links between simulation training and patient outcomes.
