Effects of simulation-based educational program in improving the nurses' self-efficacy in caring for patients' with COPD and CHF in a post-acute care (PACU) setting.

The 2014 national percentage for 30-day readmissions among Medicare recipients from Post-Acute Care Unit (PACU) showed: Heart Failure (HF) with major complications and co-morbidities, an average of 24.09%, and Chronic Obstructive Pulmonary Disease (COPD) with complications and co-morbidities 23.12%. The percentage of readmissions for New Jersey among PACU showed: HF with major complications and co-morbidities, an average of 24.40% and COPD 26.35% (Avalere Health, 2014). For this study site, the hospital readmission rate was not specifically broken down according to condition/diagnosis. Overall, the hospital readmission rate was approximately 20%. A few percent lower than the national and state average, but still a considerable number. This study is significant in finding out whether a simulation based educational program will increase the nurses' self-efficacy in caring for these patients. The positive outcome of this study can provide a template for training PACU nurses to aid in decreasing hospital readmissions in this vulnerable population. The simulation-based educational program was approximately 5h in length, and it was divided into two parts, a presentation on HF and COPD, and the actual simulation scenario, using a low-fidelity manikin (LFM). There were approximately 20 Registered nurses as participants but 4 did not complete the post-simulation self-efficacy scale, and the 16 were included in the actual study. This study was able to define the effects of simulation-based educational program on the RNs self-efficacy in caring for COPD and HF patients. The participants' demographic information, i.e. age, educational attainment, years of experience, and previous work experience, did not show any differences in how much the nurses' self-efficacy improved. The post-simulation self-efficacy score of the participants showed approximately 5% increase compared to the pre-simulation score. The outcome of the study concluded the simulation-based educational program as having a significant effect on the participants' self-efficacy post-simulation.