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Long Term Results Following the Use of a Novel Educational Program to Enhance Nursing Knowledge of Pediatric Pulmonary Hypertension

Patricia Lawrence

L Mastin

Jeryl Huckaby

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Conference: 2017 PH Professional Network Symposium

Release Date: 10.06.2017

Presentation Type: Abstracts

File Download: 2017 PHPN Abstract 1011

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Abstract presented at the 2017 PH Professional Network Symposium held in Bethesda, MD on October 5-7, 2017

Purpose

The aim of this project was to better understand what educational programs best enhance knowledge on a busy inpatient step-down unit, as well as to detail the impact of this educational program on acquired knowledge and confidence levels for its intended audience, up to eighteen months after the initial program.

Background

The nursing care and management of pediatric patients with pulmonary hypertension (PH) is complex, challenging and not widely understood. As the PH program at Children’s Healthcare of Atlanta has grown at a rapid pace, the need for an intensive educational program for nurses caring for PH patients was recognized. There is no description in the literature of effective nursing education models in pediatric pulmonary hypertension.

Methods

The unit selected for the educational program was a 27-bed cardiac step-down unit, staffed by more than 60 nurses. This 5-week long voluntary program consisted of several components. First, a test was offered to all nurses to assess knowledge in five content areas: basic PH knowledge, signs and symptoms, treatment, safety considerations, and PH crisis. All nurses were then sent a pre-intervention survey, inquiring about education needs and knowledge gaps, the largest of which was on pulmonary hypertension crisis. Survey results were used to develop educational content. A novel educational approach was used to impart knowledge, including various modes of sharing knowledge and information. Modes used for education included two articles; 3 posters, one of which focused on PH crisis; several short ‘lunch and learns’ on all nursing shifts; a daily email for 30 days which included a “PH fact of the day”; two games; and several case studies which involved utilizing critical thinking skills. At the end of the educational intervention, a survey was sent to all nurses, inquiring about confidence levels in caring for PH patients and what educational tools were most impactful and least helpful. A post-test was offered to all nurses four months after the intervention, as well as eighteen months after the intervention. 

Results

Of the more than 60 nurses who were asked to participate on a volunteer basis, 20 took both the pre- and post-test and both surveys. The post-test was given four months after the educational intervention. Of the 20 nurses, 17 improved their test score from an average of 58% to 77%. When asked to rate the education mode from most helpful to least helpful, daily emails of PH facts and oral presentation/lectures topped the list, while reading textbooks/articles and the crossword puzzle were at the bottom. Confidence was measured on a scale of 0-3, where 0 is no confidence, 1 is mildly confident, 2 moderately, and 3 is extremely confident. Average scores improved by 18% in the area of confidence to care for a PH patient, increasing from 1.7 to 2. The confidence in recognizing symptoms of PH crisis improved by 60%, increasing from 1 to 1.6, and the confidence in caring for a PH patient in crisis improved by 75%, increasing from 0.8 to 1.4. Finally, of the 20 nurses that completed the pre- and post- tests four months after the intervention, 12 of these nurses completed the same test eighteen months after the intervention. Four of the 12 nurses further improved their scores from the post-intervention test, and all 12 nurses maintained higher scores when compared to their initial, pre-intervention test scores. 

Conclusion

Based on findings, certain educational components will be left out in future educational endeavors, and the length of time will be shorter in duration. More hands-on activities and training videos will be used in the future, and more PH education will be included in new hire orientation lectures and orientation manuals. Limiting factors to the intervention included nurses' time required on a busy unit with a high turnover rate despite the 24/7 access to information and incentives.