///2013 Abstract Details
2013 Abstract Details2018-05-01T17:56:59+00:00

Teaching Labor and Delivery Nurses about Aspiration in Parturients: A “Residents as Teachers” Pilot Comparing Simulation with Didactic Lecture

Abstract Number: T 36
Abstract Type: Original Research

Agnieszka Lesicka MD1 ; Wenzhu Shi MD, PhD2; Luke Janik MD3; Kathya Gavazzi RN4; Rebecca D Minehart MD5; May C Pian-Smith MD, MS6

Background:

Parturients have an increased risk of aspiration during the peripartum period which can lead to significant morbidity. Labor and delivery nurses can play a critical role to decrease potential complications in the delivery suite and operating room. This project was undertaken to teach nurses about aspiration mechanisms, prevention and treatment. Two separate teaching modalities, powerpoint lectures vs high fidelity simulation, were employed. Simulation may improve knowledge, critical thinking, communication, and confidence which are important components of optimal teamwork. In obstetrics, where patient conditions can evolve rapidly, a multidisciplinary educational approach enhances teamwork, patient safety and outcomes.

Methods:

38 of a cohort of 50 nurses have been enrolled in a 6-month cross-over study. Pre-intervention assessment consisted of a survey on prior clinical experience and self-confidence with emergent airway management assistance, and a multiple-choice knowledge pre-test which included 10 questions on aspiration. The nurses were randomized into control (powerpoint lecture, PPT) or high fidelity simulation (SIM) groups that covered equivalent educational material developed and taught by anesthesia residents. Immediately after the intervention, the nurses repeated the survey and a knowledge post-test. After six months, performance and retention will be assessed with each nurse using knowledge tests, self assessment surveys and simulation exercises.

Results:

Pre-intervention testing demonstrated that the majority (36/38) of nurses have knowledge deficits regarding aspiration. Mean aspiration knowledge test scores improved irrespective of teaching intervention (PPT pre 6.42 ± 2.12 vs PPT post 8.79 ± 1.03; SIM pre 5.58 ± 1.53 vs SIM post 8.00 ± 1.14, p<0.001, paired t-test). There was no difference in post-intervention test scores between the PPT and SIM group (p= 0.463). Nurses reported the learning experience enjoyable, useful and rated the course 4-5/5.

Conclusion:

This pilot demonstrated the utility and feasibility of using “residents as teachers” to educate L&D nurses on increased aspiration risk and its potential complications in the parturient. Regardless of the teaching intervention used, there was a significant increase in nurse knowledge. Potential benefits of immersive simulation on long term retention will be assessed in follow up at 6 months.

References:

Chopra V, Gesink BJ, DE Jong J, Bovill JG, Spierdijk J, Brand R. Does training on an anesthesia simulator lead to improvement in performance? British Journal of Anaethesia. 1994;73:293-297.

Decker S, Sportsman S, Puetz L, Billings L. The Evolution of Simulation and Its Contribution to Competency. The Journal of Continuing Education in Nursing. 2008;39:74-80.

Quinn AC, Milne D, Columb M, Gorton H, Knight M. Failed tracheal intubation in obstetric anaesthesia: 2 yr national case–control study in the UK. British Journal of Anaesthesia 2013;110:74–80.

SOAP 2013