Obstetric (OB) nurses must be proficient in performing a basic neurologic examination to assess and detect changes in a patients' neurologic status. This study aimed to compare knowledge and skill acquisition for a basic neurologic examination between OB nurses who participated in simulation and those who participated in an online self-study module. Short- and long-term knowledge retention and skill transfer between groups were evaluated.Nurses were randomized to either simulation or online self-study module and assessed by direct observation and completion of a standardized instrument by the observer at 3 time points: baseline (time 1), within 7 days of baseline in the clinical setting (time 2), and at 2 months (time 3) using a validated12-item Neurologic Knowledge Assessment and a 14-item performance skill checklist.Among OB nurses, those in the simulation group demonstrated higher levels in both short-term (time 2) [mean (SD), 67.6 (20.2) vs. 29.6 (19.0); P < 0.001] and long-term (time 3) [mean (SD), 46.1 (17.6) vs. 27.5 (15.9); P < 0.001] skill performance compared with nurses in the online self-study module. Nurses in the simulation and online self-study module groups had similar mean levels on Neurologic Knowledge Assessment scores at time 2 (P = 0.86) and time 3 (P = 0.59), but these mean scores were not significant.The greater transfer of skills by nurses who received simulation education is an important finding because few studies have addressed this level of translation with practicing nurses. There was a lack of differences in short- and long-term knowledge acquisition between nurses in the simulation and online self-study module groups. More research is needed to determine the timing of simulation-based education repetition over time to aid in knowledge and skills retention.
The Acute Care Team Educational Initiative (ACTEI) was developed as a quality improvement initiative for the recognition and initial management of time-sensitive medical conditions. For our first time-sensitive disease process, we focused on acute stroke [acute stroke initiative (ASI)]. As part of the larger ACTEI, the ASI included creating an ACT that responds to all suspected emergency department stroke patients. In this article, we describe the planning, process, and development of the ACTEI/ASI as well as how we created an acute response team for the diagnosis and management of suspected acute stroke.
