155 Piloting a Tabletop Simulation to Prepare Nurses for Ward Coordination

Abstract

We know staff attrition is a core challenge for the NHS with many nurses leaving the profession in the first 2 years post-qualification The aim of the study was to improve retention and resilience of the nursing workforce by increasing confidence in their ability at clinical coordination.This table-top simulation pilot used a convenience sample of six staff nurses new to the role of clinical coordinator. We drew on clinical governance findings and input from experienced nurse-coordinators to simulate coordinating a shift on a surgical emergency unit. The shift was run in compressed time over 32 minutes followed by a 1.5 hour debrief. During the shift we used ‘injects’ intentionally designed to stimulate learning in: Problem solvingDecision-makingClinical processesSupporting colleagues/workforce resilienceSituational awarenessThe pilot was evaluated through peer observation and focus group. Peer observation provided an objective analysis of session content. A neutral party facilitated the focus group, which gathered data on how the training session had been received by participants and evaluated whether learning outcomes were met by content.Participants were assigned to work in pairs. Briefing was provided for session content and timeline. We used a simulated handover of patients for verisimilitude. The 12-hour shift was compressed into 4-minute segments with a ‘countdown’ timer ticking off each segment as the simulated shift progressed. This added time pressure and demonstrated how decision-making skills can be influenced by external forces. The participants had access to the hospital intranet and documented their actions/decisions on a template. Facilitated discussion took place after the tabletop simulation followed by a lunch break and then the focus group.