Compliance Behavior Clinical Trial
Official title:
Implementation of Realistic Simulation as Patient Safety Improvement Method: Controlled Trial
Realistic simulation is an effective teaching strategy for the acquisition and retention of knowledge and increased self-confidence of students, which contribute to safety in performing nursing actions.Considering the need to adopt safe practices in health since professional training, there are deficiencies in health teaching and weaknesses in the acquisition of practical skills guided by safety principles and critical clinical reasoning. The purpose is to compare the use of high fidelity simulation with traditional education as innovative method in the process of teaching and learning. This is a prospective, randomized, controlled and single-blind study, of pre-test and post-test experimental type, with application of high fidelity simulation in the theme of patient safety in administration of parenteral drugs.
Currently, the issue of patient safety has been hotly debated both nationally and
internationally, because this is a relevant issue for the health professionals' practice and
to improve the quality of patient care. According to the Institute of Medicine (IOM) report
released in 2000, a significant number of deaths in hospitals every year were related to
preventable causes and medical errors. These deaths were equal to mortality numbers due to
diseases such as cancer and HIV and car acidentes.
In this scenario, death due to errors in the process of care achieved world relevance and in
2002, the World Health Organization (WHO) released the World Health Assembly (WHA) Resolution
55.18, addressing the priorities related to patient safety in the quality of care. In 2004,
was created the World Alliance for Patient Safety on the occasion of the 57th World Health
Assembly. The World Alliance has defined programs for patient safety that must be adopted by
all member countries and therefore, by Brazil.
The general actions proposed by the WHO World Alliance for Patient Safety are oriented in
five activities among which, the efforts to strengthen the training in patient safety
worldwide. It stimulates the inclusion of a curriculum guide for patient safety in health
professional training courses .
Aspects of patient safety in medicine administration involve many health professionals.
However, nurses have an important role because they are responsible for administration and
thus, occupy the last stage between the medication and the error. For all these reasons,
safety in medication administration is a compulsory and transversal theme in the training of
nursing professionals.
In this context of search for improvements in health care planning, a new practice concept of
teaching and learning has been developed, aiming at training professionals and training the
health professionals who have already graduated.
Interests in using realistic simulation techniques have emerged lately with the objective to
encourage improvements in safety on patient care. The simulation technique amplifies the
experience of health professionals through educational actions guided by experiences that
happen in the real world, therefore, interactions must happen in a way that preserves the
most realistic aspects as possible. The adoption of simulation in health comes from
successful references of using this technique for industrial purposes and in the armed
forces. It is considered an innovative technique in health.
In high fidelity simulation, students and professionals experience clinical cases that
replicate real-world scenarios. This strategy enables teaching innovations, improves clinical
thinking in stressful situations, and prevents the exposure of patients to risks.
The realistic simulation has been integrated in the education of nurses and doctors over the
last years, but is not fully implemented yet. Despite the recommendations for using
simulation, its increasing integration in education, and the concrete evidence that its use
promotes a better prepare of health professionals for performance in clinical practice, the
empirical evidences of its impact on patient outcomes are still under developed.
Besides the realistic manikin-based simulation, virtual simulation is another way of
simulation that has been proven effective in learning strategies, contributing to the
retention of knowledge and improvement of nursing students' clinical performance.
From the increasing use of technology in health and the complexity of patients, new ways of
learning have been shaped and developed as innovative teaching methods in health care . All
these alternatives have the promising intention of reducing the deterioration of learning and
of clinical performance over time, making professionals and students able to monitor patients
in the best possible way, establish goals, priorities and better treatments.
An advantage is the possibility of students practicing their skills in an environment where
mistakes can be made and corrected without causing damages and risks to patient safety. In
addition, the construction of knowledge is established through representative situations of
day-to-day reality in professional practice, when students themselves participate as
patient-actors in a totally controlled environment, as well as protected from risks. At the
end of the activity, students and/or professionals involved in the simulation can give
feedback of their learning and, from group discussions and those with the teacher, is formed
knowledge based on self-knowledge and confidence .
PURPOSE
Primary purpose
To compare the use of high fidelity simulation with traditional education as innovative
method in the process of teaching and learning.
Secondary purpose
To propose the creation of a high fidelity scenario related to nursing care in medication
administration;
To identify the gains in theoretical and practical learning and in self-confidence of nursing
undergraduate students after undergoing high fidelity simulation in medication
administration;
To assess the effectiveness and efficiency of using high fidelity simulation in the process
of teaching and learning.
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