DOI QR코드

DOI QR Code

Effects of a Case-Based Sepsis Education Program for General Ward Nurses on Knowledge, Accuracy of Sepsis Assessment, and Self-efficacy

  • Kim, Bohyun (College of Nursing Science, Kyung Hee University) ;
  • Jeong, Younhee (College of Nursing Science, Kyung Hee University)
  • Received : 2020.09.18
  • Accepted : 2020.11.29
  • Published : 2020.11.30

Abstract

Purposes: Sepsis is a critical condition in which nurses should detect clinical manifestations and provide early intervention to prevent unwanted serious conditions in the patients. The initial occurrence and management of sepsis take place in general units, but there is a lack of knowledge in nurses. The purpose of this study was to examine the effects of a case-based sepsis education program and compare the case-based education program with and without smartphone applications. Methods: A quasi-experimental pre-test-post-test design with a control group was used. We provided a case-based education program with and without smartphone applications to the nurses and tested the effects of the program on knowledge, the accuracy of sepsis assessment, and self-efficacy as outcome variables. A total of 60 nurses in general units participated. To test differences in knowledge, the accuracy of sepsis assessment, and self-efficacy regarding sepsis between the groups over time, a mixed-design ANCOVA was used for parametric analysis, and generalized estimating equations (GEE) were used for nonparametric analysis. Results: There were significant differences in knowledge, the accuracy of sepsis assessment, and self-efficacy between the groups and within the groups over time. The intervention groups treated with the case-based education program showed improved outcome variables compared to the control group. There was no difference between case-based education with the smartphone application or without the application. Conclusions: The case-based education improved knowledge, the accuracy of sepsis assessment, and self-efficacy in the care of sepsis by nurses working in the general wards. The results suggest that the case-based education program for nurses was effective and eventually improved patient health outcomes.

Keywords

References

  1. Rudd KE, Johnson SC, Agesa KM, Shackelford KA, Tsoi D, Kievlan DR, et al. Global, regional, and national sepsis incidence and mortality, 1990-2017: analysis for the global burden of disease study. The Lancet. 2020 Jan 18;395(10219):200-211. https://doi.org/10.1016/S0140-6736(19)32989-7
  2. Torio CM, Moore BJ. National inpatient hospital costs: the most expensive conditions by payer, 2013: statistical brief #204. Healthcare Cost and Utilization Project (HCUP) Statistical Briefs. Rockville (MD); 2016.
  3. Korean Statistical Information Service. Cause of death 2019. 2020 [updated 2020 Sep 22, 2020; cited Sep 30, 2020]; Available from: http://kosis.kr/statisticsList/statisticsListIndex.do?menuId=M_01_01&&vwcd=MT_ZTITLE&&parmTabId=M_01_01.
  4. Gotts JE, Matthay MA. Sepsis: pathophysiology and clinical management. BMJ. 2016 May 23;353:i1585. https://doi.org/10.1136/bmj.i1585
  5. Rhee C, Jones TM, Hamad Y, Pande A, Varon J, O'Brien C, et al. Prevalence, underlying causes, and preventability of sepsis-associated mortality in US acute care hospitals. JAMA Netw Open. 2019 Feb 1;2(2):e187571. https://doi.org/10.1001/jamanetworkopen.2018.7571
  6. Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, et al. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock, 2012. Intensive Care Medicine. 2013 Feb;39(2):165-228. https://doi.org/10.1007/s00134-012-2769-8
  7. Nucera G, Esposito A, Tagliani N, Baticos CJ, Marino P. Physicians' and nurses' knowledge and attitudes in management of sepsis: an Italian study. Journal of Health and Social Sciences. 2018;3(1):13-26. https://doi.org/10.19204/2018/phys2
  8. Jeffery AD, Mutsch KS, Knapp L. Knowledge and recognition of SIRS and sepsis among pediatric nurses. Pediatric Nursing. 2014;40(6):271-278.
  9. Stamataki P, Papazafiropoulou A, Kalaitzi S, Sarafis P, Kagialari M, Adamou E, et al. Knowledge regarding assessment of sepsis among greek nurses. Journal of Infection Prevention. 2014;15(2):58-63. https://doi.org/10.1177/1757177413513816
  10. Yousefi H, Nahidian M, Sabouhi F. Reviewing the effects of an educational program about sepsis care on knowledge, attitude, and practice of nurses in intensive care units. Iranian Journal of Nursing and Midwifery Research. 2012;2 Suppl 1:S91-5.
  11. Stiermaier T, Herkner H, Tobudic S, Burgmann K, Staudinger T, Schellongowski P, et al. Incidence and long-term outcome of sepsis on general wards and in an ICU at the general hospital of vienna: an observational cohort study. Wiener klinische Wochenschrift. 2013;125(11-12):302-308. https://doi.org/10.1007/s00508-013-0351-1
  12. Robson W, Beavis S, Spittle N. An audit of ward nurses' knowledge of sepsis. Nursing in Critical Care. 2007;12(2):86-92. https://doi.org/10.1111/j.1478-5153.2007.00210.x
  13. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The third international consensus definitions for sepsis and septic shock (sepsis-3). JAMA. 2016;315(8):801-810. https://doi.org/10.1001/jama.2016.0287
  14. Torsvik M, Gustad LT, Mehl A, Bangstad IL, Vinje LJ, Damas JK, et al. Early identification of sepsis in hospital inpatients by ward nurses increases 30-day survival. Critical Care. 2016;20(1):244. https://doi.org/10.1186/s13054-016-1423-1
  15. Soderstrom NC, Bjork RA. Learning versus performance: an integrative review. Perspectives on Psychological Science. 2015;10(2):176-199. https://doi.org/10.1177/1745691615569000
  16. Williams B. Case based learning--a review of the literature: is there scope for this educational paradigm in prehospital education?. Emergency Medicine Journal. 2005;22(8):577-581. https://doi.org/10.1136/emj.2004.022707
  17. Forsgren S, Christensen T, Hedemalm A. Evaluation of the case method in nursing education. Nurse Education in Practice. 2014;14(2):164-169. https://doi.org/10.1016/j.nepr.2013.08.003
  18. Roshangar F, Azar EF, Sarbakhsh P, Azarmi R. The Effect of case-based learning with or without conceptual mapping method on critical thinking and academic self-efficacy of nursing students. Journal Of Biochemical Technology. 2020;11(1):37-44.
  19. Bandura A. On the functional properties of perceived self-efficacy revisited. Journal of Management. 2012;38(1):9-44. https://doi.org/10.1177/0149206311410606
  20. Franko OI, Tirrell TF. Smart phone app use among medical providers in ACGME training programs. Journal of Medical Systems. 2012;36(5):3135-3139. https://doi.org/10.1007/s10916-011-9798-7
  21. Low D, Clark N, Soar J, Padkin A, Stoneham A, Perkins GD, Nolan J. A randomised control trial to determine if use of the iResus(c) application on a smart phone improves the performance of an advanced life support provider in a simulated medical emergency. Anaesthesia. 2011;66(4):255-262. https://doi.org/10.1111/j.1365-2044.2011.06649.x
  22. Guo P, Watts K, Wharrad H. An integrative review of the impact of mobile technologies used by healthcare professionals to support education and practice. NursingOpen. 2016;3(2):66-78. https://doi.org/10.1002/nop2.37
  23. Greenfield S. Medication error reduction and the use of PDA technology. Journal of Nursing Education. 2007;46(3):127-131. https://doi.org/10.3928/01484834-20070301-07
  24. Delaney MM, Friedman MI, Dolansky MA, Fitzpatrick JJ. Impact of a sepsis educational program on nurse competence. The Journal of Continuing Education in Nursing. 2015;46(4):179-186. https://doi.org/10.3928/00220124-20150320-03
  25. Jin ES. Knowledge and Educational Needs related to Sepsis among Intensive Care Units Nurses [Master]. Ulsan, Korea (South): University of Ulsan; 2017.
  26. Sherer M, Maddux JE, Mercandante B, Prentice-Dunn S, Jacobs B, Rogers RW. The self-efficacy scale: construction and validation. Psychological reports. 1982;51(2):663-671. https://doi.org/10.2466/pr0.1982.51.2.663
  27. Yang KM. Analysis of the relationship between the empowerment, the job-related individual characteristics and the work performance of nurses. Journal of Korean Academy of Nursing Administration. 1999;5(1):39-61.
  28. The jamovi project (2020). jamovi (Version 1.2) [Computer Software]. Retrieved from https://www.jamovi.org
  29. Drahnak DM, Hravnak M, Ren D, Haines AJ, Tuite P. Scripting nurse communication to improve sepsis care. MedSurg Nursing. 2016;25(4):233-239.
  30. Tromp M, Hulscher M, Bleeker-Rovers CP, Peters L, van den Berg DT, Borm GF, et al. The role of nurses in the recognition and treatment of patients with sepsis in the emergency department: a prospective before-and-after intervention study. International Journal of Nursing Studies. 2010;47(12):1464-1473. https://doi.org/10.1016/j.ijnurstu.2010.04.007
  31. Bi M, Zhao Z, Yang J, Wang Y. Comparison of case-based learning and traditional method in teaching postgraduate students of medical oncology. Medical Teacher. 2019;41(10):1124-1128. https://doi.org/10.1080/0142159X.2019.1617414
  32. McLean SF. Case-based learning and its application in medical and health-care fields: a review of worldwide literature. Journal of Medical Education and Curricular Development. 2016;3:39-49. https://doi.org/10.4137/JMECD.S20377
  33. Garvey MT, O'Sullivan M, Blake M. Multidisciplinary case-based learning for undergraduate students. European journal of dental education. 2000;4(4):165-168. https://doi.org/10.1034/j.1600-0579.2000.040404.x
  34. Kaddoura MA. Critical Thinking skills of nursing students in lecture-based teaching and case-based learning. International Journal for the Scholarship of Teaching and Learning. 2011;5(2):Article 20. https://doi.org/10.20429/ijsotl.2011.050220
  35. Kantar LD, Massouh A. Case-based learning: What traditional curricula fail to teach. Nurse Education Today. 2015;35(8):e8-14. https://doi.org/10.1016/j.nedt.2015.03.010
  36. Rozati H, Shah SP, Shah N. Smartphone applications for the clinical oncologist in UK practice. Journal of Cancer Education. 2015;30(2):367-373. https://doi.org/10.1007/s13187-014-0681-3
  37. Manaktala S, Claypool SR. Evaluating the impact of a computerized surveillance algorithm and decision support system on sepsis mortality. Journal of the American Medical Informatics Association. 2017;24(1):88-95. https://doi.org/10.1093/jamia/ocw056
  38. Kim MS, Park JH, Park KY. Development and effectiveness of a drug dosage calculation training program using cognitive loading theory based on smartphone application. Journal Korean Academy Nursing. 2012;42(5):689-698. https://doi.org/10.4040/jkan.2012.42.5.689
  39. Bierbrier R, Lo V, Wu RC. Evaluation of the accuracy of smartphone medical calculation apps. Journal of Medical Internet Research. 2014;16(2):e32. https://doi.org/10.2196/jmir.3062
  40. Bibault JE, Leroy T, Blanchard P, Biau J, Cervellera M, Diaz O, et al. Mobile technology and social media in the clinical practice of young radiation oncologists: results of a comprehensive nationwide cross-sectional study. International Journal Radiation Oncology.Biology.Physics. 2014;90(1):231-237. https://doi.org/10.1016/j.ijrobp.2014.05.012
  41. De Bari B, Franco P, Niyazi M, Cornetto AP, Qvortrup C, Martin AN, et al. The pocketable electronic devices in radiation oncology (PEDRO) project: how the use of tools in medical decision making is changing?. Technology in Cancer Research&Treatment. 2016;15(2):365-376. https://doi.org/10.1177/1533034615572287
  42. Mavis B. Self-efficacy and OSCE performance among second year medical students. Advances in Health Sciences Education. 2001;6(2):93-102. https://doi.org/10.1023/a:1011404132508
  43. Mohamadirizi S, Kohan S, Shafei F, Mohamadirizi S. The relationship between clinical competence and clinical self-efficacy among nursing and midwifery students. International Journal of Pediatrics. 2015;3(6.2):1117-1123. https://doi.org/10.22038/ijp.2015.5222
  44. Shinnick MA, Woo MA. Does nursing student self-efficacy correlate with knowledge when using human patient simulation?. Clinical Simulation in Nursing. 2014;10(2):e71-e79. https://doi.org/10.1016/j.ecns.2013.07.006
  45. Ngo A, Murphy S. A theory-based intervention to improve nurses' knowledge, self-efficacy, and skills to reduce PICC occlusion. Journal of Infusion Nursing. 2005 May-Jun;28(3):173-181. https://doi.org/10.1097/00129804-200505000-00005
  46. Robb M. Self-efficacy with application to nursing education: a concept analysis. Nursing Forum. 2012;47(3):166-172. https://doi.org/10.1111/j.1744-6198.2012.00267.x
  47. Soper T. Knowledge into learning: comparing lecture, e-learning and self-study take-home packet instructional methodologies with nurses. NursingOpen. 2017;4(2):76-83. https://doi.org/10.1002/nop2.73
  48. Raurell-Torreda M, Olivet-Pujol J, Romero-Collado A, Malagon-Aguilera MC, Patino-Maso J, Baltasar-Bague A. Case-based learning and simulation: useful tools to enhance nurses' education? Nonrandomized controlled trial. Journal Nursing Scholarship. 2015 Jan;47(1):34-42. https://doi.org/10.1111/jnu.12113

Cited by

  1. The Knowledge of Nursing Internship Program Students about Early Detection of Sepsis vol.9, pp.t6, 2020, https://doi.org/10.3889/oamjms.2021.7602