Assessment of the multidisciplinary education for a major change in clinical practice; a prospective cohort study.
BACKGROUND
New approaches are often introduced to the neonatal intensive care unit (NICU) and other areas of the health service in either a haphazard or cataclysmic fashion. The needs of staff education are often addressed incompletely or too late. Rarely is education assessed after the introduction of a major change. We changed the basis of our NICU respiratory support. We conducted a major educational and support program before this intervention. This study documented and assessed the educational components of this change in our health service provision.


METHODS
Senior medical and nursing staff attended training abroad and an education program was applied for one year prior to the change. Multidisciplinary educational support for doctors, nurses and allied health was continued after the change. Assessment was by anonymous questionnaire, prior to change, at one and at nine months. Our hypothesis was that dissatisfaction with education would be greatest at one month.


RESULTS
Both theory education and practical education aspects of the new approach were rated as good to very good and this did not change with time. Difficulty of applying the technique was rated as ambivalent initially but decreased significantly over 9 months until it was rated easy to very easy (p < 0.001). Over all, the change was rated by staff as beneficial, both at the end of the education period and at nine months, with no decrease at one month.


CONCLUSIONS
If education and training reaches all staff, with a system of mutual and continued support, even large changes in clinical practice can be achieved without the dissatisfaction with the educational process that is often otherwise seen.
Wright
Ian M R
IM
Kaleidoscope Neonatal Intensive Care Unit, John Hunter Children's Hospital, New Lambton Heights, New South Wales, Australia. Ian.Wright@newcastle.edu.au
Wake
Chris H
CH
Anderson
Helene
H
Graham
Shirley
S
D004059:Diffusion of Innovation; D006282:Health Personnel / Q000193:education*; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D009517:New South Wales; D010818:Practice Patterns, Physicians'; D015397:Program Evaluation; D011446:Prospective Studies; D011795:Surveys and Questionnaires