title: Human patient simulation education in the nursing management of patients requiring mechanical ventilation: a randomized, controlled trial.
abstract: BACKGROUND
  Knowledge among critical care nurses and their adherence to evidence-based guidelines for preventing ventilator-associated pneumonia is reported to be low. The aim of our study was to evaluate the effectiveness of human patient simulation (HPS) education in the nursing management of patients requiring mechanical ventilation.
  
  
  METHODS
  A prospective, parallel, randomized controlled trial with repeated measurements was conducted in a 22-bed adult mixed medical-surgical intensive care unit in Finland from February-October 2012. Thirty critical care nurses were allocated evenly to intervention and control groups (n = 15 each). The effectiveness of HPS education was evaluated through the validated Ventilator Bundle Questionnaire and Ventilator Bundle Observation Schedule at baseline and repeated twice-after the clinical and simulation settings, respectivley.
  
  
  RESULTS
  After HPS education, the average skill scores (Ventilator Bundle Observation Schedule) in the intervention group increased significantly (46.8%-60.0% of the total score) in the final postintervention observation. In the average skill scores, a linear mixed model identified significant time (Pt < .001) and group (P(g) = .03) differences and time-group interactions (P(t*g) = .02) between the study groups after the HPS education. In contrast, the model did not identify any significant change over time (P(t) = .29) or time-group interactions (P(t) = .69) between groups in average knowledge scores (Ventilator Bundle Questionnaire).
  
  
  CONCLUSIONS
  Our study identified significant transfer of learned skills to clinical practice following HPS education but no influence on the level of participants' factual knowledge.
authors.affiliation: University of Oulu Graduate School, University of Oulu, Faculty of Medicine, Institute of Health Sciences, Nursing Science, Oulu, Finland; Medical Research Center Oulu, Oulu, Finland; Division of Intensive Care Medicine, Department of Anesthesia, Oulu University Hospital, Oulu, Finland. Electronic address: miia.jansson@student.oulu.fi.
authors.forename: Miia M
authors.initials: MM
authors.lastname: Jansson
authors.affiliation: Division of Intensive Care Medicine, Department of Anesthesia, Oulu University Hospital, Oulu, Finland.
authors.forename: Tero I
authors.initials: TI
authors.lastname: Ala-Kokko
authors.affiliation: Department of Anesthesiology, Oulu University Hospital, Oulu, Finland.
authors.forename: Pasi P
authors.initials: PP
authors.lastname: Ohtonen
authors.affiliation: Division of Intensive Care Medicine, Department of Anesthesia, Oulu University Hospital, Oulu, Finland.
authors.forename: Merja H
authors.initials: MH
authors.lastname: Meriläinen
authors.affiliation: Department of Infection Control, Oulu University Hospital, Oulu, Finland.
authors.forename: Hannu P
authors.initials: HP
authors.lastname: Syrjälä
authors.affiliation: Institute of Health Science, University of Oulu, Medical Research Center Oulu, Oulu, Finland.
authors.forename: Helvi A
authors.initials: HA
authors.lastname: Kyngäs
mesh_terms: D000328:Adult; D002983:Clinical Competence / Q000706:statistics & numerical data*; D004506:Education, Nursing / Q000379:methods*; D005260:Female; D005387:Finland; D006801:Humans; D008297:Male; D008875:Middle Aged; D016544:Patient Simulation; D053717:Pneumonia, Ventilator-Associated / Q000517:prevention & control*; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000009:adverse effects / Q000379:methods*
keywords: Critical care; Knowledge; Skills; Ventilator bundle