title: The FIRST²ACT simulation program improves nursing practice in a rural Australian hospital.
abstract: OBJECTIVE
  To measure the impact of the Feedback Incorporating Review and Simulation Techniques to Act on Clinical Trends (FIRST(2) ACT) simulation program on nursing observations and practice relevant to patient deterioration in a rural Australian hospital.
  
  
  METHODS
  Interrupted time series analysis.
  
  
  METHODS
  A rural Australian hospital.
  
  
  METHODS
  All registered nurses (Division 1) employed on an acute medical/surgical ward.
  
  
  METHODS
  The FIRST(2) ACT simulation program.
  
  
  METHODS
  Appropriate frequency of a range of observations and administration of oxygen therapy.
  
  
  RESULTS
  Thirty-four nurses participated (83% of eligible nurses) in the FIRST(2) ACT program, and 258 records were audited before the program and 242 records after. There were statistically significant reductions in less than satisfactory frequency of observations (P = 0.009) and pain score charting (P = 0.003). There was no measurable improvement in the administration of oxygen therapy (P = 0.143), while the incidence of inappropriate nursing practice for other measures both before and after the intervention was too low to warrant analysis.
  
  
  CONCLUSIONS
  FIRST(2) ACT was associated with measurable improvements in nursing practice.
authors.affiliation: School of Rural Health, Monash University, Melbourne, Victoria, Australia. leigh.kinsman@monash.edu
authors.forename: Leigh
authors.initials: L
authors.lastname: Kinsman
authors.forename: Penny
authors.initials: P
authors.lastname: Buykx
authors.forename: Robyn
authors.initials: R
authors.lastname: Cant
authors.forename: Robert
authors.initials: R
authors.lastname: Champion
authors.forename: Simon
authors.initials: S
authors.lastname: Cooper
authors.forename: Ruth
authors.initials: R
authors.lastname: Endacott
authors.forename: Tracy
authors.initials: T
authors.lastname: McConnell-Henry
authors.forename: Karen
authors.initials: K
authors.lastname: Missen
authors.forename: Jo
authors.initials: J
authors.lastname: Porter
authors.forename: Julie
authors.initials: J
authors.lastname: Scholes
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003422:Critical Care; D006323:Heart Arrest / Q000451:nursing; D006780:Hospitals, Rural; D006801:Humans; D007318:Inservice Training / Q000379:methods / Q000458:organization & administration*; D008485:Medical Audit; D008875:Middle Aged; D009741:Nursing Staff, Hospital / Q000193:education* / Q000592:standards; D016544:Patient Simulation; D015397:Program Evaluation; D012131:Respiratory Insufficiency / Q000451:nursing; D012189:Retrospective Studies; D014739:Victoria; D055815:Young Adult