Award Candidate Poster Presentation
‘First 3 Minutes’ resuscitation training- Developing competence and confidence in paediatric new graduate nurses.
Tuesday, May 15
09:45 - 10:45
Location: Jupiter 1&2
Context: : Graduate nurses are extremely vulnerable within their first few months of nursing practice, experiencing high levels of stress, especially when exposed to managing a resuscitation in the acute paediatric setting. Basic Life Support (BLS), training at a Paediatric hospital in Melbourne, Australia traditionally focused on the knowledge and technical skills of BLS. Reported evidence showed resuscitations were chaotic due to poor non-technical skills including leadership and communication. A unique BLS program (‘First 3 Minutes’), was implemented to build the skills required to work in a team, incorporating technical and non-technical skills to improve graduate nurses’ proficiency at responding to a real life paediatric resuscitation.
Description: : The ‘First 3 Minutes’ Basic Life support program consists of 3 modules.
1) Online eLearning, where participants are guided through the steps of the structured approach to the DRSABC and expected to complete an online quiz.
2) Correction and perfection of the skills of Bag valve mask ventilation, Guedal airway insertion and compressions where participants critiqued on their skills in timing and perfection and correction of techniques.
3) Team training scenario where participants are given a realistic scenario within their environment, and they practice within real time with real equipment with real teams for 3 minutes which has been identified to be the average amount of time it would be before the emergency team would arrive. An education plan was developed and implemented to enhance the newly registered nurse’s capability to recognise and anticipate the deteriorating paediatric patient, while also developing technical and non-technical (human factors) skills required to work in a team environment.
Observation/Evaluation: : Six months post ‘First 3 Minutes’ training, pre and post- intervention surveys were administered to evaluate retention of knowledge and level of confidence in technical and non-technical skills. These skills were also observed in a repeated ‘First 3 minutes’ training scenario at the six months evaluation period by trained BLS assessors using a standardised BLS assessment tool and the Team Emergency Assessment Measure (TEAM) tool. The results of the pre-survey identified graduates perceived themselves as very vulnerable in all areas of BLS algorithm including their understanding of the non-technical skills (human factors). After undertaking the ‘First 3 Minutes’ scenario, level of confidence and skills were identified as consciously incompetent. This was evident in both the technical and non-technical skills. The facilitators discussed the areas they needed to work on including the knowledge component and the skills required to perform in the scenario through the debrief session facilitated after the scenario. The nurses were given another opportunity to participate in the same scenario to optimise their performance. Both the technical and nontechnical skills were observed to have improved dramatically since the second repeated training scenario. This was also confirmed by the nurses in the post survey as consciously competent.
Discussion: : Effective team work and skill coordination are essential to the effective management of a resuscitation in an acute clinical setting. The use of strategic well-constructed education programs will ensure a safe and supportive environment in which new graduate nurses can develop the skills, knowledge, confidence and clinical competence when working as a part of a collaborative team in a resuscitation scenario.
The Royal Children's Hospital, Melbourne
Parkville, Victoria, Australia