A preliminary study of a novel emergency department nursing triage simulation for research applications View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2017-01-03

AUTHORS

Steven L. Dubovsky, Daniel Antonius, David G. Ellis, Werner Ceusters, Robert C. Sugarman, Renee Roberts, Sevie Kandifer, James Phillips, Elsa C. Daurignac, Kenneth E. Leonard, Lisa D. Butler, Jessica P. Castner, G. Richard Braen

ABSTRACT

BackgroundStudying the effect on functioning of the emergency department of disasters with a potential impact on staff members themselves usually involves table top and simulated patient exercises. Computerized virtual reality simulations have the potential to configure a variety of scenarios to determine likely staff responses and how to address them without intensive utilization of resources. To decide whether such studies are justified, we determined whether a novel computer simulation has the potential to serve as a valid and reliable model of on essential function in a busy ED.MethodsTen experienced female ED triage nurses (mean age 51) mastered navigating a virtual reality model of triage of 4 patients in an ED with which they were familiar, after which they were presented in a testing session with triage of 6 patients whose cases were developed using the Emergency Severity Index to represent a range of severity and complexity. Attitudes toward the simulation, and perceived workload in the simulation and on the job, were assessed with questionnaires and the NASA task load index. Z-scores were calculated for data points reflecting subject actions, the time to perform them, patient prioritization according to severity, and the importance of the tasks. Data from questionnaires and scales were analyzed with descriptive statistics and paired t tests using SPSS v. 21. Microsoft Excel was used to compute a correlation matrix for all standardized variables and all simulation data.ResultsNurses perceived their work on the simulation task to be equivalent to their workload on the job in all aspects except for physical exertion. Although they were able to work with written communications with the patients, verbal communication would have been preferable. Consistent with the workplace, variability in performance during triage reflected subject skill and experience and was correlated with comfort with the task. Time to perform triage corresponded to the time required in the ED and virtual patients were prioritized appropriately according to severity.ConclusionsThis computerized simulation appears to be a reasonable accurate proxy for ED triage. If future studies of this kind of simulation with a broader range of subjects that includes verbal communication between virtual patients and subjects and interactions of multiple subjects, supports the initial impressions, the virtual ED could be used to study the impact of disaster scenarios on staff functioning. More... »

PAGES

15

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s13104-016-2337-3

DOI

http://dx.doi.org/10.1186/s13104-016-2337-3

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https://app.dimensions.ai/details/publication/pub.1007743508

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/28057048


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26 schema:description BackgroundStudying the effect on functioning of the emergency department of disasters with a potential impact on staff members themselves usually involves table top and simulated patient exercises. Computerized virtual reality simulations have the potential to configure a variety of scenarios to determine likely staff responses and how to address them without intensive utilization of resources. To decide whether such studies are justified, we determined whether a novel computer simulation has the potential to serve as a valid and reliable model of on essential function in a busy ED.MethodsTen experienced female ED triage nurses (mean age 51) mastered navigating a virtual reality model of triage of 4 patients in an ED with which they were familiar, after which they were presented in a testing session with triage of 6 patients whose cases were developed using the Emergency Severity Index to represent a range of severity and complexity. Attitudes toward the simulation, and perceived workload in the simulation and on the job, were assessed with questionnaires and the NASA task load index. Z-scores were calculated for data points reflecting subject actions, the time to perform them, patient prioritization according to severity, and the importance of the tasks. Data from questionnaires and scales were analyzed with descriptive statistics and paired t tests using SPSS v. 21. Microsoft Excel was used to compute a correlation matrix for all standardized variables and all simulation data.ResultsNurses perceived their work on the simulation task to be equivalent to their workload on the job in all aspects except for physical exertion. Although they were able to work with written communications with the patients, verbal communication would have been preferable. Consistent with the workplace, variability in performance during triage reflected subject skill and experience and was correlated with comfort with the task. Time to perform triage corresponded to the time required in the ED and virtual patients were prioritized appropriately according to severity.ConclusionsThis computerized simulation appears to be a reasonable accurate proxy for ED triage. If future studies of this kind of simulation with a broader range of subjects that includes verbal communication between virtual patients and subjects and interactions of multiple subjects, supports the initial impressions, the virtual ED could be used to study the impact of disaster scenarios on staff functioning.
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32 schema:keywords BackgroundStudying
33 Department
34 ED
35 ED triage
36 ED triage nurses
37 Emergency Severity Index
38 Excel
39 MethodsTen
40 Microsoft Excel
41 NASA Task Load Index
42 ResultsNurses
43 SPSS v. 21
44 Severity Index
45 Task Load Index
46 accurate proxy
47 action
48 applications
49 aspects
50 attitudes
51 broad range
52 busy ED
53 cases
54 comfort
55 communication
56 complexity
57 computer simulations
58 computerized simulation
59 computerized virtual reality simulation
60 correlation matrix
61 data
62 data points
63 descriptive statistics
64 disaster scenarios
65 disasters
66 effect
67 emergency department
68 essential functions
69 exercise
70 exertion
71 experience
72 function
73 functioning
74 future studies
75 impact
76 importance
77 impression
78 index
79 initial impression
80 intensive utilization
81 interaction
82 jobs
83 kind
84 kind of simulation
85 load index
86 matrix
87 members
88 model
89 multiple subjects
90 novel computer simulation
91 nurses
92 patient exercise
93 patient prioritization
94 patients
95 performance
96 physical exertion
97 point
98 potential
99 potential impact
100 preliminary study
101 prioritization
102 proxy
103 questionnaire
104 range
105 range of severity
106 reality model
107 reality simulation
108 reliable model
109 research applications
110 resources
111 response
112 scale
113 scenarios
114 sessions
115 severity
116 simulation data
117 simulation tasks
118 simulations
119 skills
120 staff functioning
121 staff members
122 staff responses
123 standardized variables
124 statistics
125 study
126 subject skills
127 subjects
128 subject’s actions
129 such studies
130 t-test
131 table top
132 task
133 test
134 testing sessions
135 time
136 top
137 triage
138 triage nurses
139 triage simulation
140 utilization
141 variability
142 variables
143 variety
144 variety of scenarios
145 verbal communication
146 virtual patients
147 virtual reality model
148 virtual reality simulation
149 work
150 workload
151 workplace
152 z-score
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