Simulation Resources and Needs: A Statewide Perspective from Florida

Transcription

1 Simulation Resources and Needs: A Statewide Perspective from Florida

2 Mary Lou Sole, PhD, RN, CCNS, FAAN, FCCM Mary Elizabeth Betsy Guimond, PhD, ARNP Christina Amidei, MSN, RN, CCRN 2

3 Partners Investing in Nursing s Future (PIN) grant awarded to the Blue Foundation of Florida in partnership with the Florida Center for Nursing Promoting the Use of Simulation Technology in FL Nurse Education 3

4 PIN Grant Goal Maximize use of simulation technology in the preparation of new and continuing education of current RNs in Florida, thus addressing the nursing shortage by increasing the nurse supply through increased production and retention. 4

5 Project Overview Simulation is a potential strategy for increasing nursing workforce Simulation permitted to substitute up to 25% of clinical practice hours Data needed to determine how simulation used in educational and practice settings

6 Two-Year Project Year One Information Gathering Data Collection Analysis of Results Year Two Identify a strategic approach to achieve goal Develop state/regional implementation model 6

7 Advisory Panel / Project Team Advisory Panel Representatives of FONE; FACN; FCNEA; APNEF; Health Facility and Academic Simulation Centers; Simulation Industry National Expert Consultant Project Team Co- Leaders: The Blue Foundation and FCN Research Team: UCF College of Nursing Focus Group Consultants Evaluation Consultants 7

8 Simulation Definition An educational practice, process, or strategy designed to imitate the workplace or clinical environment. Experiences designed for the learner to demonstrate knowledge, skills, decision making, and critical thinking. Often incorporates technology and devices developed for various purposes, such as a computer enhanced mannequin.

9 Survey Sent N=407 RN/LPN Schools Deans/directors Hospitals CNO Electronic Analysis by school and hospital, and by region Unable to Deliver Considered Received Responses N=22 Schools 1 Hospitals 21 N=385 Schools 179 Hospitals 206 N=210 (54.5%) Schools 132 (73.7%) Hospitals 78 (37.9%) Unique Responses N=185 Schools 119 Hospitals 66

10 Simulation Substitution for Clinical Practice Hours Program N* Clinical Hours Mean Clinical Hours Median Simulation Substitute Hours Mean Mean % Simulation Substituted LPN % ADN % BSN % All %

11 13.5% 25.9% 47.6% 55.1% 80.0% 78.9% 100% 90% 80% SIMULATION EQUIPMENT Schools own more equipment than hospitals Greater percentage of facilities own lowfidelity equipment 70% 60% 50% 40% 30% Overall Schools Hospitals 20% 10% 0% Static mannequin Task trainer Simulator Standard Patient Haptic System Virtual Reality Availability of Simulation Equipment across Schools and Hospitals

12 Coordination, Staffing, Training Simulation Coordinator at 26.3% of sites 30% schools vs. 20% hospitals Characteristics 70.7% Work full-time 87.8% RNs 65.8% Master s degree or higher 90.0% Received training Technical Support Personnel at 13.5% of sites Other Personnel at 37% of sites; usually faculty members

13 Medium to High Fidelity Simulators Owned by 57.3% of sites Total 716 devices Median 4 per site Majority adult mannequins Schools owned more simulators than hospitals Mean of 7.9 vs. 3.1 devices Hospitals more likely to own certain simulators Advanced cardiac life support % of Mannequins by Category Baby 20% Obstetric 11% Pediatric 15% Other 1% Adult 53%

14 Simulators by Region Regions with the highest populations and numbers of schools and hospitals had the largest number of simulators (East Central, West Central, and South) The two regions with lowest populations, schools, and hospitals reported fewest number of simulators (Northwest and Southwest)

15 Warranties Purchased by less than half of sites (48.1%) Schools buy more often than hospitals (51% vs. 40%) Often included as part of grant proposals, but not renewed when grant funding ended Purchase Warranties YES Excessive use necessitates need Cost of repair is expensive Access to technical support Troubleshooting problems Prevent downtime Funds available to purchase Purchase Warranties NO Cost of warranty Limited duration of warranty

16 30.8% 26.5% 20.5% Additional Equipment to Support Simulation 13.0% 9.7% Additional Equipment 40% 35% 30% 25% 20% More schools owned equipment than hospitals Overall 15% 10% 5% Schools Hospitals 0% Camera Microphone Control Panel Archival software Equipment to Transmit

17 Space and Services Space 41.8% had a dedicated simulation laboratory Schools twice as likely as hospitals to have space Lab space varied widely, up to 13,000+ sf Hours used for simulation ranged 0-42 hrs/week and 0-20 hrs/weekend Services 20 sites offer simulation-related services: Education, consultation, and technical support 12.6% reported purchasing services: On-site training, software, and scenarios

18 9.6% 4.8% 4.8% 3.4% 17.8% 37.0% 80.8% Simulation Funding 100% 90% 80% 70% 60% 50% Funding varied Over 1/3 multiple funding sources 47.4% of schools 14.3% of hospitals 40% 30% Overall 20% 10% School 0% Hospital Sources of Funding to Support Simulation

19 Simulation Applications to the Clinical Setting Schools Medical-surgical, maternal-newborn, pediatric education Hospitals Medical-surgical, critical care, emergency/ trauma/disaster, and perioperative/anesthesia education More multidisciplinary training

20 Issues Related to Scenarios Writing Lack of time to develop scenarios Limited number of faculty skilled to write Editing those written by others Important to have a degree of control over the content and objectives

21 24.3% 23.8% 43.8% 61.6% Future Plans 80% 70% 60% 43.8% of respondents reported future plans 50% 40% Overall 30% 20% Schools Hospitals 10% 0% Use simulation more Purchase equipment Construct/add space Hire personnel Future Plans for Simulation

22 16.4% 51.5% 48.0% 42.7% 39.8% 39.2% Challenges and Needs 80% Greatest challenge: Financial support 70% 60% 50% 40% 30% 20% 10% Overall Schools Hospitals 0% Inadequate finances Lack of educator knowledge Lack of time Lack of equipment Lack of technical support Lack of buyin Challenges Associated with Simulation

23 Partnership Alliances Reasons FOR Alliance Networking / skill improvement Offset equipment or facilities cost Variety of simulation equipment Additional learning opportunities Collaboration already established Optimize clinical time Reasons AGAINST Alliance Time and distance for travel Current simulation lab meets needs Difficult to send staff off-site Lack of scheduling flexibility Potential legal issues Alternative clinical sites desirable

24 Partnership Challenges Scheduling or time concerns Cost Distance/travel Competition Equipment misuse Unknown qualifications of staff using simulation equipment

25 If additional resources, would Expand simulation offerings Purchase equipment Hire additional support staff Renovate existing facilities or build new space Increase training for faculty or staff Develop or establish simulation program Offer programs/education to other entities (hospital/health department)

26 Focus Group Validation 8 regional focus groups conducted Findings mirrored those obtained via online survey 26

27 Summary and Recommendations

28 Educational Opportunities Provide a mechanism for sharing knowledge and resources through local and regional coalitions and conferences. Create a statewide web-based resource center. Develop a workshop series for faculty education and training. Consider offering such a series regionally to facilitate access

29 Research Opportunities Facilitate development of partnerships between interested researchers to evaluate outcomes of simulation. Develop a small-grants program to facilitate research in best practices and outcomes. Seek funds from industry and other interested parties to provide unrestricted grant support for research projects.

30 Collaboration Opportunities Develop and encourage local and/or regional partnerships among hospitals and schools Identify guidelines for establishing successful partnership, such as joint use agreements, cost sharing, and other responsibilities. Develop a mechanism for regional technical support for repair and programming of equipment

31 Scenario Development Opportunities Develop a simulation scenario library that is tailored to the learning objectives of individuals programs. Convene small groups with common interests to develop scenarios that meet learning needs of specific groups. Provide educational opportunities for educators to learn to write and edit scenarios.

32 Future Steps Think Tank held January 2011 Wrote a new PIN grant application; not funded Future directions Establish a virtual simulation resource center in Florida Establish mechanism for technical support Promote regional collaboration 32

33 Thank You! Questions? 33