Application of Patient Simulators Combined with Internet plus Scenario Simulation Teaching Models on Intravenous Infusion Nursing Education in China ()
1. Introduction
IV infusion is one of the most effective and direct treatments in clinical practice. Statistics show that there are approximately 5 billion people receiving IV therapy in China every year, and 85% of nurses spend more than 75% of their total working time on IV infusions [1] . However, the risks of IV infusion have increased despite the development of medical technology and infusion equipment, and the scientificity, effectiveness, and safety of IV therapy have also attracted much attention. A large number of studies indicate that the incidence of IV therapy complications can be significantly reduced if IV nurses can identify the complications and provide targeted preventive intervention promptly [2] [3] . Therefore, it is necessary to adopt advanced and practical nursing education methods and update course content to cultivate skillful IV nurses to provide safe and effective IV therapy [4] [5] .
2. Data and Methods
2.1. Data
Data were collected from 60 nurses who took the IV infusion therapy training program in our hospital from January 2022 to December 2023. 30 nurses aged 27 - 40 (mean age 32.7 ± 3.3) who were trained from January to December 2022 were enrolled in the control group, and 30 nurses aged 29 - 40 (mean age 33.1 ± 3.6) who were trained from January to December 2023 were enrolled in the experimental group. Two groups were comparable regarding the above information with no statistical significance (P > 0.05).
2.2. Inclusion Criteria
1) Bachelor’s degree or above; at least five years of clinical experience and obtain a nurse practitioner certificate. 2) Voluntarily participate in this research and sign a consent form.
2.3. Exclusion Criteria
1) No participation in other research. 2) Intern nurses. 3) Take leave for more than five consecutive days.
3. Methods
3.1. Teaching Methods
Teaching content included the improvement of IV infusion therapy management and quality, assessment of IV sites, prevention and control of infusion-related infection, assessment and treatment of complications, patient safety and practices, including PICC catheterization and central venous catheter maintenance, which were all taught by IV therapy experts in our hospital. The control group was educated with traditional teaching methods, including lectures, demonstrations, and group discussions. Professors taught them theoretical knowledge related to IV infusion therapy using slides, and the nurses had group discussions based on the course content after class. After finishing the theoretical part, educators would take them to nursing rounds every morning, demonstrating and explaining the key points of IV therapy. Then the nurses practiced under guidance, and educators would give them feedback and advice and answer their questions afterwards. The experimental group adopted the patient simulators combined with Internet Plus scenario simulation teaching models. Methods included lectures with slides, scenario simulation with patient simulators, recorded educational videos, WeChat group discussions, flipped classrooms, workshops, clinical demonstrations, case analysis, and critical thinking questions, in order to encourage inquiry-based learning. For instance, educators would create multimedia presentations about typical PICC maintenance cases with images, medical videos, references and clinical consultations, etc., to demonstrate the meaning and approaches of PICC maintenance to nurses in an all-round, multi-level and three-dimensional manner. In addition, videos of every nurse’s IV therapy operation under scenario simulation would be recorded and shared in the group chat for peer evaluation and self-evaluation. Then educators would review and recapitulate the main points of IV therapy standards and pathology regarding their performance, and guided them to practice again with simulation technology to correct errors.
3.2. Evaluation Indicators
3.2.1. Assessment Based On CINS and PSI, and Evaluation of Comprehensive Learning Ability and Scientific Research Ability
Evaluated nurses’ clinical competence with CINS (43 items on six factors) [6] , ranging from 43 to 301 points (the higher the better). Evaluated nurses’ problem-solving ability with PSI (25 items on five factors) [7] , ranging from 25-125 points (the higher the better). Recorded and compared the comprehensive learning ability and scientific research ability of the two groups.
3.2.2. Assessment of Theoretical Knowledge, Practical Skills and Nursing Quality
Practical skills assessment results were evaluated by educators and head nurses based on nurses’ practical skills, teamwork skills and other abilities through bedside demonstrations and scenario simulations, etc., rating from 0 to 100. Theoretical knowledge was assessed with a closed-book exam, grading from 0 to 100.
3.2.3. IV Cather-Related Complications
Recorded related complications such as bleeding, infection, catheter blockage, mechanical phlebitis, etc.
3.2.4. Nurse Satisfaction with Teaching Methods
A questionnaire-based survey was conducted to evaluate nurse satisfaction with educators and the quality of teaching content. Grading system (0 - 100 points): satisfied (>90 points), quite satisfied (80 - 89 points), dissatisfied (<80 points). Satisfaction rates were measured based on the number of nurses rating satisfied and quite satisfied.
3.3. Statistical Methods
Data were analyzed by SPSS26.0. The results were compared with an independent samples t-test indicating with (
), and a chi-square test indicating with %. P < 0.05 was considered statistically significant.
4. Results
4.1. Comparisons of CINS Scores, Comprehensive Learning Ability, Scientific Research Ability
As shown in Table 1, the two groups’ CINS scores, comprehensive learning ability, and scientific research ability before training were considered no statistical significance (P > 0.05). However, the post-training results of the experimental group in those three aspects were improved compared to those of the control group, indicating statistical significance (P < 0.05).
4.2. Comparisons of PSI Scores
As shown in Table 2, the two groups’ PSI scores before training were considered no statistical significance (P > 0.05). However, the post-training PSI scores of the experimental group were higher than those of the control group with statistical significance (P < 0.05).
4.3. Comparisons of the Assessment Results of Theoretical Knowledge, Nursing Quality and Practical Skills
As shown in Table 3, the two groups’ assessment results of theoretical knowledge, nursing quality and practical skills before training indicated no statistical significance (P > 0.05). However, the post-training assessment results of the experimental group in those three aspects were better than those of the control group with statistical significance (P < 0.05).
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Table 1. Comparisons of CINS scores, comprehensive learning ability, scientific research ability [(
), points].
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Table 2. Comparisons of PSI scores [(
), points].
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Table 3. Comparisons of the assessment results of theoretical knowledge, nursing quality and practical skills [(
), points].
4.4. Comparisons of the Incidence of Complications
As shown in Table 4, the incidence of catheter-related complications in the experimental group was lower than that of the control group with statistical significance (P < 0.05).
4.5. Comparisons of Nurse Satisfaction with Different Teaching Methods
As shown in Table 5, the overall satisfaction rate in the experimental group was higher than that of the control group with statistical significance (P < 0.05).
5. Discussion
1) At present, IV infusion is an extremely common treatment in clinical medicine which takes up almost 90% of nurses’ working time [8] [9] . Studies reveal that IV therapy is soaring in popularity along with the rapid development of clinical medicine and medical equipment in recent years, which demands skillful IV nurses and stricter management and safety policies [10] [11] . Research also shows that IV infusion nursing education can improve nurses’ ability to identify
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Table 4. Comparisons of the incidence of complications [n (%)].
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Table 5. Comparisons of nurse satisfaction with different teaching methods [n (%)].
and prevent infusion-related complications and is of great significance in improving the safety of treatment [12] . Scenario simulation teaching methods, which have been widely used in nursing education, have proved effective for promoting student engagement and encouraging better communication and positive learning outcomes. However, it requires experienced educators, specific teaching venues and facilities, and there are also limitations, such as limited teaching hours and difficulty in reflecting individual differences [13] [14] . Thus, this study is designed to evaluate the effectiveness of patient simulators combined with Internet Plus scenario simulation teaching models on IV therapy nursing education.
2) Some studies have shown that scientific nursing teaching models are crucial to the improvement of nursing staff’s comprehensive quality, professional knowledge and nursing skills [15] . Simulation-based teaching model focuses on encouraging independent learning, and creating a better emotional experience and an active learning atmosphere, which contributes significantly to enhancing the quality of nursing education and nurses’ learning efficiency and professional skills [16] [17] . According to the results of this study, applying patient simulators combined with Internet Plus scenario simulation teaching models on IV therapy nursing education can significantly improve nurses’ professional competence, comprehensive learning ability, and scientific research ability.
3) Nursing training should pay more attention to cultivating and improving nursing staff's ability to identify and solve problems, thereby enhancing the safety of clinical treatment, and reducing the incidence of complications and adverse reactions for better patient recovery. This study shows that participants’ overall PSI scores are improved under patient simulators combined with Internet Plus scenario simulation teaching models, indicating that the application of this teaching model can effectively improve IV nurses’ problem-solving ability possibly because it can mimic real situations in clinical practice, including patients’ symptoms and vital signs.
Some scholars stated in their studies that the fundamental purpose of nursing education is to develop knowledgeable professionals capable of providing safe, highly competent, and skilled patient care [18] [19] [20] . This study indicates that the assessment results of participants’ theoretical knowledge, practical skills and the quality of nursing care were significantly improved under patient simulators combined with Internet Plus scenario simulation teaching models. Based on the outcomes, it is believed that the implementation of this teaching model can make great contributions to the enhancement of IV nurses’ professional knowledge and skills to achieve high-quality nursing care.
4) Meanwhile, this study also finds that the value of simulation-based teaching models is demonstrated by a lower incidence of complications and increased nurse satisfaction.
6. Conclusion
In conclusion, nursing education with patient simulators combined with Internet Plus scenario simulation teaching models allows students to learn more directly and engage in practice and self-study anytime and anywhere, and can improve IV nurses’ professional skills and knowledge, core competencies, problem-solving ability, comprehensive learning ability in an effective learning environment, and also reduces the incidence of complications.
Acknowledgements
Medical Science and Technology Research Fund Project of Guangdong Province (B2021370), Leading Specialist Construction Project-Department of the First Affiliated Hospital, Jinan University (2022225).