Board #247 - Program Innovation Engaging Learners in an Annual Nursing Staff Competency Blitz through Video Simulations (Submission #9201)

Abstract

Objectives The annual nursing staff competency blitz is the primary vehicle by which new initiatives are deployed and skill completions are recorded for over 3800 staff in a Midwestern hospital. Global problems of crowding, noise, and confusion have arisen due to the number of attendees. These factors, as well as job pressures such as staffing shortages, and patient acuity, led to a culture of “Swipe and Run” for many. The participant’s goal became to get credit for completion of stations in the shortest time possible and return to the unit, avoiding non-compliance. It was impossible to accurately assess individual competency. Drastic changes in the Blitz were made, based on participant feedback, benchmarking, and QI data. Topics were aligned with National Nursing Quality Indicators while standardizing information, practices, competency determination and teaching methodology (e.g. on-line modules and video simulations) to be used. Primary objectives of the new program included: 1) Learner would actively engage in the annual nursing competency Blitz through completion of on-line modules and review of video simulations; 2) Learner would assimilate key practices of Nursing Sensitive Quality Indicators to improve patient outcomes. (Specific critical behaviors for each indicator were covered.). Description An interactive delivery model was developed through the collaboration of clinicians at the hospital and faculty at the affiliated university. The High Impact Learning Theory, an adult learning theory, was used to design our intervention. The Blitz intervention included pre-requisite work—which included online learning modules with embedded questions and a pre-test—followed by face-to-face participation in two 20-minute simulation videos. The simulation videos were based upon the nursing sensitive quality indicators: restraint alternatives, pressure ulcer & fall prevention, catheter associated urinary tract infection prevention, infection control, deep vein thrombosis prophylaxis, and stroke recognition & intervention. Facilitated groups of approximately 8-10 nursing staff viewed the videos, with debriefing after specified clips. This methodology required staff to actively participate—identifying risk factors, interventions, and/or actions during simulations—rather than receiving credit for just attending. Following the debriefing, each staff member was required to take a post-test to ensure competency. Facilitators of the debriefing were provided training around successful debriefing, which included a standardized manual with detailed information related to each topic. Conclusion Over 1,500 staff nurses and 500 assistive personnel participated in the nursing competency blitz over a two-week time frame. Overall, the nursing staff was very positive about the format and use of simulation to ensure competency. Approximately 48% of staff rated the use of video simulations for Blitz as being extremely effective (e.g. 10 on a 1-10 scale), with over 86% rating the effectiveness at an 8 or higher. Time to complete the competencies was much less (715 total hours) than expected (1400 hours) based on previous years. Improvements in competency were noted for both staff nurses (improvement in scores of 34% from pre- to post-test) and assistive personnel (improvement of 27% pre- to post-test). Use of simulation may help bridge the current gap in practice and annual competency. Findings from this project provide evidence of successful implementation of simulation into an annual nursing competency blitz in a large health system. We successfully aligned our topics with national nursing quality indicators and institutional quality improvement initiatives while standardizing information, practices, competency determination and teaching methodology within the annual staff competency blitz. Disclosures None