Validation of an evaluation instrument for responders in tactical casualty care simulations

Development and validation of assessment instruments for cervical collar and spinal board placement in simulated environments for nursing students in the care of polytrauma patients

BACKGROUND

Multiple trauma injuries are the leading cause of death and disability in people under the age of 45 and require prompt and specialised care. However, medical and nursing education programmes do not always include specific training in emergency pre-hospital care, resulting in a lack of basic practical skills in trauma management.

OBJECTIVE

To develop and validate two instruments for assessing nursing students' competence in cervical collar and spinal board application in simulated pre-hospital emergency scenarios.

METHOD

This is an instrumental study that involves the development of two assessment instruments and the evaluation of their psychometric properties in a sample of 392 nursing students. Content validity was assessed using expert judgement, by calculating the content validity ratio (CVR) for each item and the scale level content validity index average (S-CVI/Ave) for the instruments. Exploratory factor analysis using the MINRES extraction method and Promax rotation was performed to analyse the performance of the items and structure of the rubrics. Internal consistency was analysed using the Omega coefficient and inter-rater agreement was assessed using Cohen's Kappa coefficient.

RESULTS

Initially, two rubrics were obtained: one with six items for cervical collar placement (S-CVI/Ave = 0.86) and one with nine items for spinal board placement (S-CVI/Ave = 0.81). Both had a single-factor structure, with all items having factor loadings greater than 0.34 for the cervical collar rubric and 0.56 for the spinal board rubric, except for item 2 of the cervical collar rubric (λ = 0.24), which was subsequently removed. The final cervical collar rubric (five items) had an overall internal consistency of 0.84 and the spinal board rubric had an overall internal consistency of 0.90, calculated using the Omega statistic. The weighted Kappa coefficient for each item ranged from acceptable (0.32) to substantial (0.79). These results show that we have successfully developed two sufficiently valid instruments to assess the immobilisation competencies proposed in the objective of the study.

CONCLUSION

Whilst further research is needed to fully establish their psychometric properties, these instruments offer a valuable starting point for evaluating nursing students' competence in cervical collar and spinal board application in simulated pre-hospital scenarios.

Learning outcomes and cost-utility analysis of hybrid patient and mannequin-based simulation

INTRODUCTION

There is no clear evidence on the relationship between nursing student learning outcomes and the type of simulator used or its cost-effectiveness.

OBJECTIVES

Compare nursing student learning outcomes using either the hybrid patient or mannequin and the cost-utility of both simulators.

METHOD

A randomised experimental study with an experimental group (hybrid patient = 99) and a control group (mannequin = 97). A training intervention was carried out for polytrauma patients.

RESULTS

Statistically significant differences were found between the simulator used and the performance results for tourniquet (hybrid 5.37 ± 1.33, mannequin 4.95 ± 1.09; p = .008) and spinal board (hybrid 6.18 ± 2.02, mannequin 6.97 ± 20.2; p = .001) application. The cost-utility ratio was estimated to be 3.29 for the hybrid patient and 1.92 for the mannequin.

CONCLUSION

The use of a hybrid patient or mannequin has not been shown to be a determinant of performance outcomes or student perceptions in training interventions in polytrauma patient care. However, as the cost per participant with a mannequin is almost twice as high, the hybrid patient has a better cost-utility ratio.

Evaluation of the Impact of a Tourniquet Training Program: A Cross-Sectional Study

Among the main preventable causes of death in the area of operations is external exsanguinating hemorrhage in the extremities, hence the importance of the tourniquet as a therapeutic tool in this type of injury and, therefore, of the training of personnel participating in international missions. The main objective of this study is to determine the impact of training in the application of this device. This is a quasi-experimental, prospective, cross-sectional study, carried out with 97 healthy volunteers, military personnel who perform their work in the Royal Guard barracks of El Pardo. The study was conducted between June 2019 and July 2021. The correct determination of the device placement site and the times of correct device placement were evaluated by determining whether there was blood flow using Doppler ultrasound measurements. Statistically significant results were obtained for application time (76.68 s to 58.06 s; p < 0.001), correct device placement (p < 0.001), and achievement of complete ischemia in the upper extremity (23.7% pretest vs. 24.7% post-test; p < 0.001). In the lower extremity, after training, longer application duration (43.33 s to 47.30 s) and lower ischemia achievement (59.8% pretest vs. 37.8% post-test) were obtained. Standardized and regulated training improves device application. More intensive training is necessary to obtain better results.

Nursing staff's instrument for change-of-shift reporting - SBAR (Situation-Background-Assessment-Recommendation): validation and application

OBJECTIVES

to validate and apply a change-of-shift instrument using the SBAR (Situation-Background-Assessment-Recommendation) tool.

METHODS

methodological study for the validation of an instrument. It was validated by ten judges from the area of nursing teaching and care and applied in a surgical gastroenterology ward by 11 nursing technicians in February 2019. The analyses considered descriptive statistics.

RESULTS

the judges analyzed the instrument with a content validity index of 91.7% and made suggestions, which led to the second version of the instrument. The participants reported that the predominant modality of shift handover is oral, in the nursing room, lasting six to ten minutes. Most pay attention during shift change, mention that delays and early departures interfere in the activity and believe that the instrument provides the necessary information and is viable.

CONCLUSIONS

the instrument built was validated, and its application proved relevant, as it was considered necessary and feasible.

Instrumento de passagem de plantão da equipe de enfermagem - SBAR (Situation-Background-Assessment-Recommendation): validação e aplicação

RESUMO Objetivos: validar e aplicar instrumento de passagem de plantão utilizando a ferramenta SBAR (Situation-Background-Assessment-Recommendation). Métodos: estudo metodológico para a validação de instrumento. O instrumento foi validado por dez juízes da área de ensino e assistência de enfermagem e aplicado em uma enfermaria de gastroenterologia cirúrgica por 11 técnicos de enfermagem no mês de fevereiro de 2019. As análises consideraram a estatística descritiva. Resultados: os juízes analisaram o instrumento com índice de validade de conteúdo de 91,7%, fizeram sugestões gerando a segunda versão do instrumento. Os participantes referiram que a modalidade de passagem de plantão predominante é oral, na sala de enfermagem, de 6 a 10 minutos. A maioria presta atenção na passagem de plantão, refere que atrasos e saídas antecipadas interferem, acreditam que o instrumento possui informações necessárias e é viável. Conclusões: o instrumento construído foi validado e sua aplicação evidenciou a relevância, pois considera-se o instrumento necessário e viável.