Student nurses show poor skills in treating deteriorating patients
Final year student nurses have performed poorly in an experiment designed to test their understanding of and ability to deal with deteriorating patients.
The simulation involved 51 final-year student nurses and combined quantitative measures of the trainees’ knowledge, skill and situation-awareness, as well as a qualitative review of how decisions were made.
The video-recorded scenarios involved hypovolaemic and septic shock on mannequins. Each simulation was stopped at random points and students were asked questions to measure their level of awareness of what was taking place.
The researchers found that when the condition of the “patient” deteriorated, so did the students’ own response.
How a patient’s condition ended up seemed heavily dependent how well staff identified and managed the deterioration.
The mean knowledge score was 74% (range 46-100%) and the mean skill-performance score across both scenarios was 60% (range 30-78%).
Student performance markedly improved for the second scenario, but when the condition of the patients in both scenarios got worse, the students’ skill performance worsened significantly during the tests.
The mean situation-awareness score for the two scenarios was 59% (range 38-82%).
Students were more inclined to identify physiological causes for the deterioration (77%) but scored badly on their understanding of what went on (44%).
The findings, which are published in the Journal of Clinical Nursing, showed that the students’ ability to manage patient deterioration is poor.