726: SIMULATION CURRICULUM TO IMPROVE NURSING-LED EARLY MOBILITY OF CRITICALLY ILL CHILDREN

Abstract

Introduction: Early pediatric intensive care unit (PICU) mobilization is safe and associated with improved clinical outcomes. Nurses are the sole PICU staff involved in the majority of mobilizations. Nursing-specific mobility training is desired, improves ICU mobilization compliance, and increases nursing confidence in mobilizing higher-risk patients. Simulation is superior to traditional instruction methods for teaching clinical skills. Thus, the aim of this study is to design and implement a nurse-targeted, simulation-based early mobility curriculum to determine if it improves nurse self-efficacy, knowledge, and skills. Methods: We conducted a pre-post interventional study of PICU nurses. We developed and deployed a half-day simulation curriculum. The educational strategy included group simulations, debriefing sessions, and didactic sessions. The early mobility self-efficacy assessment was on a Likert scale from 1 (not confident) to 4 (very confident). The knowledge assessment was a 20 question test. Individual skills were assessed using a 25 item rubric during Observed Structured Clinical Examinations (OSCE). Results: Data was compiled from 11 PICU nurses who participated in a half-day simulation-based early mobility curriculum. The nurses who participated had a median of 2 years (Interquartile Range [IQR], 0.7-3) of nursing experience and 1.5 years (IQR, 0.7-2.5) of PICU experience. Participation in the curriculum improved the early mobility self-efficacy score from a median of 2.7 (IQR 2.67-3) to a median of 3.6 (IQR 3.1-3.7; p-value 0.001). Knowledge assessment test scores also improved from a median of 14 (IQR 12-16) questions correct to a median of 17 (IQR 16-18) questions correct (p-value 0.001). Additionally, nurses completed more clinical skills during the OSCE with an improvement from a median of 14 (IQR 13.5-16) items to 18 (IQR 17-19) items (p-value 0.002). Conclusions: Development of a simulation-based early mobility curriculum is feasible. Hands-on early mobility education for nurses improves self-efficacy, knowledge, and clinical skills mobilizing critically ill children.