The impact of web-based and face-to-face simulation on patient deterioration and patient safety: protocol for a multi-site multi-method design.
There are international concerns in relation to the management of patient deterioration which has led to a body of evidence known as the 'failure to rescue' literature. Nursing staff are known to miss cues of deterioration and often fail to call for assistance. Medical Emergency Teams (Rapid Response Teams) do improve the management of acutely deteriorating patients, but first responders need the requisite skills to impact on patient safety.



In this study we aim to address these issues in a mixed methods interventional trial with the objective of measuring and comparing the cost and clinical impact of face-to-face and web-based simulation programs on the management of patient deterioration and related patient outcomes. The education programs, known as 'FIRST(2)ACT', have been found to have an impact on education and will be tested in four hospitals in the State of Victoria, Australia. Nursing staff will be trained in primary (the first 8 min) responses to emergencies in two medical wards using a face-to-face approach and in two medical wards using a web-based version FIRST(2)ACTWeb. The impact of these interventions will be determined through quantitative and qualitative approaches, cost analyses and patient notes review (time series analyses) to measure quality of care and patient outcomes.



In this 18 month study it is hypothesised that both simulation programs will improve the detection and management of deteriorating patients but that the web-based program will have lower total costs. The study will also add to our overall understanding of the utility of simulation approaches in the preparation of nurses working in hospital wards. (ACTRN12616000468426, retrospectively registered 8.4.2016).
School of Nursing Midwifery and Healthcare, Federation University Australia, Churchill, Victoria 3842 and Mt. Helen, Victoria 3350, Australia. s.cooper@federation.edu.au.
Simon J
SJ
Cooper
School of Nursing, The University of Tasmania, PO Box 1322, Launceston, Tasmania, 7250, Australia.
Leigh
L
Kinsman
School of Nursing Midwifery and Healthcare, Federation University Australia, Churchill, Victoria 3842 and Mt. Helen, Victoria 3350, Australia.
Catherine
C
Chung
School of Nursing Midwifery and Healthcare, Federation University Australia, Churchill, Victoria 3842 and Mt. Helen, Victoria 3350, Australia.
Robyn
0000-0001-5430-3275
R
Cant
St John of God Health Care Berwick, Gibb St, Berwick, Victoria, 3806, Australia.
Jayne
J
Boyle
Department of Nursing and Midwifery Education and Strategy, Monash Health, Clayton Rd, Clayton, Victoria, 3168, Australia.
Loretta
L
Bull
Latrobe Regional Hospital, 10 Village Ave, Traralgon, VIC, 3844, Australia.
Amanda
A
Cameron
Nursing and Midwifery, Monash University, McMahons Rd, Frankston, Victoria, 3199, Australia.
Cliff
C
Connell
School of Nursing Midwifery and Healthcare, Federation University Australia, Churchill, Victoria 3842 and Mt. Helen, Victoria 3350, Australia.
Jeong-Ah
JA
Kim
Central Gippsland Health Service, 155 Guthridge Parade, Sale, VIC, 3850, Australia.
Denise
D
McInnes
School of Nursing, The University of Tasmania, PO Box 1322, Launceston, Tasmania, 7250, Australia.
Angela
A
McKay
Department of Nursing and Midwifery Education and Strategy, Monash Health, Clayton Rd, Clayton, Victoria, 3168, Australia.
Katrina
K
Nankervis
College of Medicine, University of Saskatchewan, Saskatoon, SK, S7N 5E5, Canada.
Erika
E
Penz
College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, S7N 5E5, Canada.
Thomas
T
Rotter
D003194:Computer-Assisted Instruction / Q000592:standards; D003299:Cooperative Behavior; D006780:Hospitals, Rural; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data*; D009726:Nurses; D061214:Patient Safety; D016544:Patient Simulation; D011787:Quality of Health Care; D012189:Retrospective Studies; D012720:Severity of Illness Index; D000066908:Simulation Training / Q000592:standards
Clinical audit; E-simulation; Education; Nursing; Patient safety; Simulation-based learning