Does Simulation Training for Acute Care Nurses Improve Patient Safety Outcomes: A Systematic Review to Inform Evidence-Based Practice.

Abstract

Simulation is increasingly used as a training tool for acute care medical-surgical nurses to improve patient safety outcomes. A synthesis of the evidence is needed to describe the characteristics of research studies about acute care nurse simulation trainings and patient safety. An additional purpose is to examine the effects of acute care registered nurse (RN) simulation trainings on patient safety outcomes. Five Internet databases were searched for articles published on any date through October 2018 examining the effect of RN simulation trainings on patient safety outcomes in the adult acute care setting. N=12 articles represented 844 RNs of varying experience levels and 271 interprofessional participants. Nine studies (75%) used high-fidelity scenarios developed locally about high risk but infrequent events. Five studies (42%) incorporated interdisciplinary team members in the scenarios and/or outcome evaluations. Outcome measures were self-reported, direct observation, or clinical indicators. All studies in this review achieved improved patient safety outcomes. It is unknown how outcomes vary for different groups of RNs because of insufficient gender, ethnicity/race, and age reporting. Findings support the design of simulation training research studies for patient safety outcomes and use of simulation training and research in acute care RNs. Additional high-quality research is needed to support this field. Future studies should include descriptors that characterize the sample (i.e., age, gender, education level, type of nursing degree, ethnicity or race, or years of experience); incorporate interdisciplinary teams; evaluate a combination of outcome measure types (i.e., self-report, direct observation, and clinical outcomes) both proximal and distal to the simulation; and that utilize standardized scenarios, validated outcome measure instruments, and standardized debriefing tools.