Michele L Kuszajewski1, John M O'Donnell2, Paul E Phrampus3, Walter C Robey4, Patricia K Tuite5. 1. Duke University School of Nursing, Center for Nursing Discovery, Durham, NC, USA. Electronic address: michele.kuszajewski@duke.edu. 2. Department of Nurse Anesthesia, University of Pittsburgh School of Nursing, Pittsburgh, PA, USA; Peter M. Winter Institute for Simulation, Education, and Research (WISER), University of Pittsburgh, Pittsburgh, PA, USA. 3. University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Peter M. Winter Institute for Simulation, Education, and Research (WISER), University of Pittsburgh, Pittsburgh, PA, USA. 4. East Carolina University Brody School of Medicine, Clinical Simulation Program, Greenville, NC, USA. 5. University of Pittsburgh School of Nursing, Pittsburgh, PA, USA.
Abstract
OBJECTIVE: Airway assessment and management are vital skills for the critical care transport provider. Nurses and paramedics often enter a transport program with limited or no exposure to airway management. Many programs lack a structured curriculum to show skill competence. Optimal methods in the development of airway management competence and the frequency of training needed to maintain skills have not been clearly defined. Because of this lack of standardization, the actual level of competence in both new and experienced critical care transport providers is unknown. METHODS: A pretest, post-test repeated measures approach using an online curriculum combined with a deliberate practice model was used. Competence in airway management was measured using 3 evaluation points: static mannequin head, simulation scenario, and the live patient. RESULTS: A convenience sample of critical care transport providers participated (N = 9). Knowledge improvement was significant, with a higher percentage of participants scoring above 85% on the post-test compared with the pretest (P = .028). Mean scores in completion of the airway checklist pre- versus postintervention were significantly increased on all 3 evaluation points (P < .001 for all comparisons). Significant changes were noted in the response profile evaluating participants' confidence in their ability to verbalize indications for endotracheal intubation (P < .05). CONCLUSION: The development of a standardized, blended learning curriculum combined with deliberate simulation practice and rigorous assessment showed improvements in multiple areas of airway assessment and management.
OBJECTIVE: Airway assessment and management are vital skills for the critical care transport provider. Nurses and paramedics often enter a transport program with limited or no exposure to airway management. Many programs lack a structured curriculum to show skill competence. Optimal methods in the development of airway management competence and the frequency of training needed to maintain skills have not been clearly defined. Because of this lack of standardization, the actual level of competence in both new and experienced critical care transport providers is unknown. METHODS: A pretest, post-test repeated measures approach using an online curriculum combined with a deliberate practice model was used. Competence in airway management was measured using 3 evaluation points: static mannequin head, simulation scenario, and the live patient. RESULTS: A convenience sample of critical care transport providers participated (N = 9). Knowledge improvement was significant, with a higher percentage of participants scoring above 85% on the post-test compared with the pretest (P = .028). Mean scores in completion of the airway checklist pre- versus postintervention were significantly increased on all 3 evaluation points (P < .001 for all comparisons). Significant changes were noted in the response profile evaluating participants' confidence in their ability to verbalize indications for endotracheal intubation (P < .05). CONCLUSION: The development of a standardized, blended learning curriculum combined with deliberate simulation practice and rigorous assessment showed improvements in multiple areas of airway assessment and management.
Authors: Adam Ryason; Emil R Petrusa; Uwe Kruger; Zhaohui Xia; Vanessa T Wong; Daniel B Jones; Suvranu De; Stephanie B Jones Journal: J Educ Perioper Med Date: 2020-01-01