Enhancing the Clinical Competency of Newly Graduated Nurses via Scenario-based Clinical Skills Workshops

Abstract Description

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Authors (including presenting author) :

Lam KCH (1), Woun YSB (1), Ding WH (1), Ip WH (1), Chan A (1), Sze MK (1), Leung YL (2), Lee A (2), Mak F (2), Ng M (3), Leung CP (4)

Affiliation :

(1) Nursing Services Division, Ruttonjee & Tang Shiu Kin Hospitals (2) Department of Medical & Geriatrics, Ruttonjee & Tang Shiu Kin Hospitals (3) Anaesthesia, OT, O&T, Surgery & CEU, Ruttonjee & Tang Shiu Kin Hospitals (4) Accident and Emergency Department & SOPD, Ruttonjee & Tang Shiu Kin Hospitals

Introduction :

Since 2018, the Ruttonjee & Tang Shiu Kin Hospitals have begun to provide more hands-on working opportunities, in a safe and protected environment, to strengthen the knowledge, skills and attitudes required in high risk clinical procedures for newly graduated nursing staff. To this end, a series of Scenario-based Workshops on 3 common, but high risk, clinical skills have been conducted, including 1) Tracheostomy Care; 2) Central-Line Care; and 3) Chest Drain Care, for all the newly graduated nurses recruited in 2017/18 by RTSKH. These scenario-based Clinical Skill Workshops were done in purpose-built skills labs within the RTSKH ward, functioning as training facilities, offering all health care staff a fault-forgiving and protected environment for the practice of clinical skills (Bugaj & Nikendei, 2016).

Objectives :

That these scenario-based Clinical Skill Workshop can help the participants, especially the newly graduated nurses recruited in 2017/18 by RTSKH, have skills acquisition and assessment in the move from novice to expert: • Indications of a related procedure • preparation of patient, environment & equipment for the related procedure • performing the safety check of bedside procedure (before & after) • performing patient care during the related procedure • handling of specimens, if any • correct & adequate documentation • handling of emergency situations

Methodology :

The alignment sessions were conducted with experienced nurses from clinical departments to align with the clinical practice concepts & clarify questions on related clinical skills. Pre-reading reference materials (or E-book), including related Nursing standards for Patient Care; and information were distributed to the participants via email 7-14 days before the workshop started. The Assessment forms, based on the related ‘Nursing Standards for Patient Care Basic & Advanced Practice Standards’ from HAHO (2015) were prepared and reviewed by local expert nurses and endorsed by senior nurse managers before the skill assessment sessions began. A 30-minute individual skill assessment session was arranged for each skill for each participant. A skill-specific scenario was provided to participants to practice the related material & documents. Onsite demonstrations and return demonstrations, from the preparation of equipment, patient and environment; demonstration of nursing skills; aftercare and daily care and documentation, were done and assessed by clinical preceptors. A structured debriefing was given to each participant which helped the learner to identify gaps, or the need for more learning to improve their knowledge, skills or professional behavior. Course evaluation forms on skill related knowledge and comment were given to each participant to fill in after each skill assessment session.

Result & Outcome :

From April to May, 2017, a total of 120 individual skill assessment sessions were completed. 92.5% of these sessions were undertaken by 2017 freshly graduated nurses. The overall compliance on assessments was 85.19% to 99.24%. 81.67% of the participants had study the ‘pre-reading’ material before the sessions. All of the participants indicated that they ‘agreed’ to ‘strongly agreed’, that the program was useful. Participants who had study the ‘pre-reading’ information material generally did better in the skill assessment. From the results and comments yielded, Scenario-based Clinical Skill Workshops are helpful in reinforcing the ‘need to know’ of the three clinical skills involved. Demonstration videos may be useful to better the understanding of the information contained in the pre-reading material.