Stopping extremity hemorrhage: More than just a tourniquet

Effectiveness of a Haemorrhage-Control Task Simulator for Training Nursing Students: A Quasi-Experimental before-after Study

Aim

To assess the efficacy of a low-cost haemorrhage-control task simulator integrated in a high-fidelity simulation scenario to facilitate knowledge and practical skills acquisition, as well as self-efficacy in haemorrhage control among nursing students.

Design

A quasiexperimental before-after design was conducted at the University of Almeria.

Methods

A one-group preintervention, immediate postintervention, and a third assessment at three months were performed, with the Stop the Bleed Education Assessment Tool used to evaluate knowledge of haemorrhage control, as well as a 5-point Likert scale used to evaluate perceived self-efficacy. The success of controlling exsanguinating bleeding was determined by quantifying the millilitres lost during the intervention and calculating the time required to control the haemorrhaging. The data were reported using the TREND guidelines.

Results

One hundred and three final-year nursing students participated in this study. Significant improvements (p < 0.001) were observed in pre- and posttest total scores on knowledge of bleeding control, self-efficacy, as well as time is taken and volume loss to control the haemorrhage. Similar results were observed between preassessment and three months postassessment with significant improvements (p < 0.001) in all measures.

Conclusions

The use of a haemorrhage-control task simulator within a high-fidelity simulation scenario resulted in noteworthy improvements in nursing students' practical skills, knowledge retention, and self-efficacy. After three months, performance decreased but remained greater than pretraining levels. Thus, broadening the use of this task-training simulator would be of great value to further develop a first responder training approach with healthcare professionals and other laypersons, allowing for greater knowledge distribution and reaching a larger audience. Implications for Nursing Management. The findings underscore the potential efficacy of this simulator as a valuable resource for nursing educators and supervisors to train nursing students and professionals in terms of practical skills, knowledge retention, and self-efficacy in haemorrhage control, fostering a train-the-trainer cascade approach to reach a wider audience and enhance bleeding control proficiency among professionals.

Developing a translational triage research tool: part two-evaluating the tool through a Delphi study among experts

Background

There are different prehospital triage systems, but no consensus on what constitutes the optimal choice. This heterogeneity constitutes a threat in a mass casualty incident in which triage is used during multiagency collaboration to prioritize casualties according to the injuries’ severity. A previous study has confirmed the feasibility of using a Translational Triage Tool consisting of several steps which translate primary prehospital triage systems into one. This study aims to evaluate and verify the proposed algorithm using a panel of experts who in their careers have demonstrated proficiency in triage management through research, experience, education, and practice.

Method

Several statements were obtained from earlier reports and were presented to the expert panel in two rounds of a Delphi study.

Results

There was a consensus in all provided statements, and for the first time, the panel of experts also proposed the manageable number of critical victims per healthcare provider appropriate for proper triage management.

Conclusion

The feasibility of the proposed algorithm was confirmed by experts with some minor modifications. The utility of the translational triage tool needs to be evaluated using authentic patient cards used in simulation exercises before being used in actual triage scenarios.