Abstract:

There is substantial literature about New Graduate Nurses (NGN’s) perceptions of readiness for code blue management or their perceived comfort level in recognizing and responding to a change in patient condition. However, there is minimal quantitative data available on the outcomes for simulation-based training for code blue responses. There is a paucity in literature describing interventions that incorporate assessment such as Objective Structured Clinical Exams (OSCE).

The purpose of the study is to address a gap in knowledge concerning new graduate nurses’ perceptions of their comfort and confidence levels when participating in a rapid response or code. The study will also provide quantitative and qualitative data on the effect of simulation on the NGN’s ability to recognize, respond to and deploy a rapid response or code.

The quasi-experimental mixed methods study will employ the use of a standardized high-fidelity simulation activity and Objective Structured Clinical Exam (OSCE) with a pre-/posttest. Data analysis will consist of quantitative statistical analysis and Naturalistic Inquiry methods to obtain qualitative data. Guided interviews with semi-structured, open-ended questions will be utilized. Participant responses will be recorded and transcribed. The team will be scored as a group for the simulation performance while individual competence will be assessed via a brief questionnaire at the end of the simulation. The OSCE will be evaluated according to a rubric/checklist utilizing binary scoring of pass/fail and participant score on resuscitation quality utilizing video capture and simulation software. The theoretical framework of interest is Erickson’s Role Modeling and Benner’s Novice to Expert theory. The debriefing model used was the Advocacy-Inquiry Method to encourage self-reflection of learner actions. The justification for the selected study design is that the pre-/posttest with an intervention can detect effect or causality. The population of study is new graduate nurses currently in orientation or residency programs.

Results 80 students participated in the study. There was a statistically significant difference between pre-/post scores (p-value <0.001). There was an improved recognition of patient decline among new graduate nurses post nursing simulation activity.

Learning Objectives:

1. Evaluate resuscitation quality in new graduate nurses using nursing simulation.
2. Integrate and apply organizational policy and procedures during simulated nursing activities.
3. Describe best practices through academic discourse among healthcare simulationists.