University of Oulu

Jansson, M. M., Syrjälä, H. P., Ohtonen, P. P., Meriläinen, M. H., Kyngäs, H. A. and Ala‐Kokko, T. I. (2017), Effects of simulation education on oral care practices – a randomized controlled trial. Nurs Crit Care, 22: 161-168. doi:10.1111/nicc.12276

Effects of simulation education on oral care practices : a randomized controlled trial

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Author: Jansson, Miia M.1,2,3; Syrjälä, Hannu P.4; Ohtonen, Pasi P.5;
Organizations: 1Oulu University Hospital, Division of Intensive Care, Department of Anesthesiology, Oulu, Finland
2Unit of Nursing Science and Health Management, University Oulu, Finland
3Medical Research Center Oulu Finland
4Oulu University Hospital, Chief of Department of Infection Control, Medical Research Center, Oulu, Finland
5Oulu University Hospital, Department of Anesthesiology, Oulu, Finland
6Medical Research Center Division of Intensive Care, Department of Anesthesiology, Oulu University Hospital, Oulu, Finland
7Medical Research Center, Northern Ostrobothnia Hospital Unit of Nursing Science and Health Management, Oulu, Finland
8Oulu University Hospital, Oulu, Finland
9Medical Research Center, Division of Intensive Care, Department of Anesthesiology, Oulu, Finland
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 0.3 MB)
Persistent link: http://urn.fi/urn:nbn:fi-fe2019061420458
Language: English
Published: , 2017
Publish Date: 2019-06-14
Description:

Abstract

Background

Implementation of evidence‐based oral care protocols, nurse education programmes and assessment tools may reduce the risk of developing ventilator‐associated pneumonia by increasing critical care nurses' knowledge and skills in adhering to current oral care recommendations.

Aims

To evaluate the longitudinal effects of single‐dose simulation education with structured debriefing and verbal feedback on critical care nurses' knowledge and skills in adhering to current oral care recommendations.

Design

A randomized controlled trial with repeated measurements.

Method

The data for the study were collected in a single academic centre in a 22‐bed adult, mixed, medical‐surgical intensive care unit in Finland from February 2012 to March 2014. The effectiveness of simulation education was evaluated through the validated Ventilator Bundle Questionnaire and Observation Schedule at baseline (n = 30) and 24 months (n = 17) after simulation education. Data were analysed using a linear mixed model and intention‐to‐treat analyses.

Results

During the study period, the average knowledge score in the intervention group increased significantly (44·0% to 56·0% of the total score) in the final post‐intervention measurement (pt = 0·51, pg = 0·002, pt*g = 0·023). However, single‐dose simulation education with structured debriefing and verbal feedback had no impact on critical care nurses' skill scores.

Conclusion

Single‐dose simulation education had only a minimal effect on critical care nurses' knowledge and skills in adhering to current oral care recommendations. Despite increased awareness, there was no significant difference in oral care practices between the study groups after simulation education.

Relevance for clinical practice

The need for regularly repeated educational sessions with theoretical training and practical exercises and direct feedback is evident. Certain aspects of oral care, such as prevention of microaspiration of oropharyngeal secretions and moistening of oral mucosa and lips, require more reinforcement than others.
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Volume: 22
Issue: 3
Pages: 161 - 168
DOI: 10.1111/nicc.12276
OADOI: https://oadoi.org/10.1111/nicc.12276
Type of Publication: A1 Journal article – refereed
Field of Science: 316 Nursing
Subjects:
Copyright information: © 2017 British Association of Critical Care Nurses. This is the peer reviewed version of the following article: Jansson, M. M., Syrjälä, H. P., Ohtonen, P. P., Meriläinen, M. H., Kyngäs, H. A. and Ala‐Kokko, T. I. (2017), Effects of simulation education on oral care practices – a randomized controlled trial. Nurs Crit Care, 22: 161-168. doi:10.1111/nicc.12276, which has been published in final form at https://doi.org/10.1111/nicc.12276. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.