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Volume 3 Supplement 1

ESICM LIVES 2015

  • Poster presentation
  • Open Access

A collaborative approach to training ward nurses in acute care skills in resource limited settings: the nursing intensive care skills training (nicts) project

  • 1,
  • 2, 3,
  • 4,
  • 4,
  • 5,
  • 4,
  • 4,
  • 6,
  • 5,
  • 7,
  • 8 and
  • 4, 7, 8
Intensive Care Medicine Experimental20153 (Suppl 1) :A445

https://doi.org/10.1186/2197-425X-3-S1-A445

  • Published:

Keywords

  • Acute Care
  • Clinical Skill
  • Resource Limited Setting
  • Pass Mark
  • Ward Nurse

Introduction

Early recognition and prevention of deterioration of ward patients can improve patient outcomes and reduce critical care admissions [1]. In low and middle income countries (LMICs), with often minimal access to critical care therapies, the benefit may be even greater. However training to assist ward nurses develop acute care skills remains limited in such settings. As part of the NICST portfolio of acute care training, the Sri Lankan nursing faculty sought assistance to deliver a 2 day course for ward nurses [2].

Objectives

To design a clinically relevant short course for ward nurses in a LMIC to be delivered by local nursing tutors and facilitators.

To assess whether such a clinically focused programme would increase ward nurses' knowledge and skills in identifying and managing deteriorating patients.

Methods

A multi-modal 2 day acute care course for ward nurses was co-designed and delivered by specialist overseas trainers in partnership with national tutors. The courses were sponsored by the Ministry of Health, Sri Lanka. Based upon the NICST model of collaborative course design, local faculty were up skilled in delivery and content through a pre course Train the Trainer programme [3].

Candidates were invited to undertake on-line pre course e-learning. Core clinical guidelines were delivered using mini lectures. Facilitator-led skills stations and structured scenarios were used to develop clinical skills.

Short term knowledge acquisition was tested by a pre and post course Multi-Choice Questionnaire (MCQ). Newly acquired skills and their application was assessed through a post course Objective Clinical Skills Assessment (OSCA) station.

Results

122 ward nurses were trained over 6 courses in 2 locations. Post MCQ scores were significantly higher for each course compared to pre MCQ (Wilcoxon sign rank test P < 0.0001).

Over 71% passed the OSCA (pass mark of 60). Feedback reveals high candidate satisfaction.

Conclusions

Our short course results demonstrate an increase in relevant knowledge and clinical skills of the participants. Our NICST model demonstrates the feasibility of a local nursing faculty in a LMIC co-designing and effectively delivering a setting adapted acute care training programme integrated into the local nurse training system.
Table 1

Ward course pre and post course results.

Time

Venue

Number of faculty members trained

Number of trainees

Pre Course MCQ mean (SD)

Post course MCQ mean (SD)

P value

2014 June

Colombo

21

31

66.3 (14.8)

80.3 (11.2)

0.0007

2014 September

Colombo

20

14

53.2 (9.3)

67.4 (9.9)

0.0016

2014 October

Moneragala

16

27

51.0 (14.4)

73.3 (11.8)

0.0001

2014 November

Colombo

13

13

52.0 (7.0)

65.3 (8.6)

0.0074

2015 March

Moneragala

11

20

46.8 (10.6)

65.8 (7.9)

0.0001

2015 March

Colombo

18

17

48.9 (14.6)

67.6 (12.7)

0.0144

Table 2

Selected course candidate feedback.

Evaluation

Strongly agree' and 'agree' combined

 

June (n = 27)

Sept (n = 8)

Oct (n = 23)

Nov (n = 13)

March PBCN (n = 11)

March M'ragala (n = 20)

I acquired new knowledge and skills

27 (100%)

7 (87.5%)

22 (95.7%)

13 (100%)

11 (100%)

20 (100%)

The sessions were supported with adequate demonstration of intensive care skills

25 (96.1%)

7 (87.5%)

22 (100%)

13 (100%)

11 (100%)

20 (100%)

The information in lectures was conveyed clearly

23 (85.2%)

8 (100%)

21 (95.5%)

13 (100%)

11 (100%)

19 (95%)

I got adequate opportunity for hands-on experience

24 (92.3%)

7 (87.5%)

20 (90.9%)

12 (92.3%)

11 (100%)

15 (88.2%)

I found the content relevant to my practice

24 (100%)

7 (87.5%)

21 (100%)

13 (100%)

11 (100%)

20 (100%)

Authors’ Affiliations

(1)
Adult Critical Care Department, Barts Health NHS Trust, London, United Kingdom
(2)
Critical Care Research Team, Barts Health NHS Trust, London, United Kingdom
(3)
Queen Mary University of London, William Harvey Institute, London, United Kingdom
(4)
National Intensive Care Surveillance, Colombo, Sri Lanka
(5)
Ministry of Health, Office of Deputy Director General (Education, Training and Research), Colombo, Sri Lanka
(6)
Nursing Council of Sri Lanka, Colombo, Sri Lanka
(7)
Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
(8)
Mahidol Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand

References

  1. Spearpoint KG, Gruber PC, Brett SJ: Impact of the Immediate Life Support course on the incidence and outcome of in-hospital cardiac arrest calls: an observational study over 6 years. Resuscitation. 2009, 80 (6): 638-643. 10.1016/j.resuscitation.2009.03.002.PubMedView ArticleGoogle Scholar
  2. Acute care training from Sri Lanka to the developing world. NICS Training [Online] Available from: http://nics-training.com/?page_id=507 [Accessed 01:04:15]
  3. De Silva AP, Stephens T, Welch J, Sigera C, De Alwis S, Athapattu P, et al: Nursing intensive care skills training: a nurse led, short, structured, and practical training program developed and tested in a resource-limited setting. J Crit Care. 2015, 30 (2): 438.e7-11. 10.1016/j.jcrc.2014.10.024.View ArticleGoogle Scholar

Copyright

© Beane et al.; 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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