Authors (including presenting author) :
Lam SS(1), Au W(1), Tse KYG(1), Lee OKA(1)
Affiliation :
(1)Department of Medicine and Geriatric, Ruttonjee and Tang Shiu Kin Hospitals.
Introduction :
Stroke is an acute clinical condition requiring early assessment and treatment. The benefits of intravenous plasminogen activator in patient with ischemic stroke are time-dependent [1]. Acute Stroke Unit(ASU) nurses play an important role in assessing and managing stroke patient in hyper-acute stroke pathway. Their competence including self-confidence, clinical judgement, ability to prioritize and problem-solving skill are the determinants of the effectiveness of hyper-acute stroke management. Simulation training is a way in enhancing nurses’ knowledge and experience without compromising patient safety [2]. It provides nurses opportunities to encounter difficult and rare scenarios which may enhance their coping skills and reduce their fear and stress in real-life clinical situation [3,4].
Half-day simulation training workshop with scenarios focus on hyper-acute stroke management was designed for ASU nurses. It was arranged to conduct in the simulation training center.
Objectives :
To enhance competence of ASU nurses
To enhance self-confidence of ASU nurses
Methodology :
Participants were required to study the knowledge and standard from the learning materials before workshop. Scenarios were scripted to simulate different problems and level of difficulties for participants to handle. After each scenario, facilitators debriefed on participants’ performance and advice on their competence through group discussion.
Standard hyper-acute stroke assessing skill checklist was designed from the pre-course learning material and was used to assess the competence of participants. Survey on pre and post self-report confidence level in managing acute stroke and post course evaluation were conducted afterward.
Result & Outcome :
Six ASU nurses attended the workshop on 1st March 2019. Their experience in acute stroke management ranged from 1 to 7 years. Participants were competent on acute-stroke management with 100% fulfillment on competence assessment part. All of them completed the survey on self-confidence before and after the workshop. There was an increase in self-confidence level in managing hyper-acute stroke from 27.1% to 83.3%. Overall satisfaction to this course was 5.8 out of 6. All participants agreed that training through simulated scenarios was useful to self-evaluate their competency and identify area for improvement. They agreed that debriefing session would enhance their confidence to handle problems through critical thinking. Overall, they found the style of training is helpful for them to solve problems in real practice. Hyper-acute stroke management involves collaboration of multi-disciplines and inter-departments. In the future, training workshop can be extended to the participants from multi-disciplinary and inter-departmental. That may foster communication and cooperation between team members and ultimately enhance the quality of hyper-acute stroke care.
