Simulation-based training module on urosepsis improves knowledge and skills of urology nurses in Karachi, Pakistan: A brief project report

Simulation-based training has become an essential part of medical and healthcare education. The purpose of this project was to evaluate the improvement in knowledge and skills of nurses by introducing a new training methodology simulation-based training module. A ‘cause and effect’ tool was used to identify care concerns and learning needs experienced by urology nurses in patient care settings. Early identification and management of sepsis/urosepsis was identified as a learning theme. A timeline was set and the Institute for Healthcare Improvement Quality Improvement Model, methodology was used to enact a plan-do-study-act cycle to develop a strategy for project execution. To improve care provided by urology nurses and to improve the clinical outcomes, a biannual traditional training course for urology nurses was refurbished converting it into a simulation-based training module. Via this module nursing staff gained knowledge about a standard sepsis protocol and were able to perform focused assessment on a high fidelity SimMan 3G® simulator. Staff were further able to identify early signs of urosepsis and demonstrate an ability in its initial management. Participants had skills signed off at the end of simulation-based training session. Improvement in knowledge was assessed by multiple choice questions following pre and post-tests. An online evaluation form was filled by each participant to assess effectiveness of module and strengths, weaknesses opportunities, threats (SWOT) analysis was done. Fifty four out of 93 nurses within a Nephrology-Urology service participated. Improvement in knowledge was calculated by pre-test average score about recognition and early management of sepsis which was 59%, with an average post-test score of 75%. Besides this, nurses were evaluated for skills sign off with at least a ‘satisfactory’ performance. At the end of the session evaluation forms were completed by the participants to determine the perceived usefulness of the training. A SWOT analysis identified the main strength of the project which was that it offered hands-on skills to identify early warning signs of sepsis along with the opportunity to practice the management of these issues efficiently. Simulation-based module significantly improved the knowledge and skills of urology nurses and participants demonstrated a positive attitude toward this new pedagogy.