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Critical care training needs analysis for ward staff

Introduction

Our Trust recently established a critical care outreach service. The objectives of the team are to enhance the quality and continuity of care for critically ill patients and to share critical care skills with ward staff. Historically, critical care areas within the Trust have experienced a reluctance from ward nursing staff to accept patients back into the ward area who still require a high level of nursing intervention. It became apparent that skill deficits existed among the ward staff and highlighted the need for more skills training. The aim of this study was to conduct a training needs analysis to ensure that future skills training was based on the ward staff's perceived needs as opposed to those perceived by the outreach team.

Method

A questionnaire was distributed to a random sample of 139 nursing staff of all grades across the Trust. It asked respondents to report knowledge, competence and confidence in the following areas of care: tracheostomy, central lines, CVP monitoring, CPAP, ECG monitoring, airway suction and oxygen therapy. Respondents were also asked to report on the frequency with which they used these skills.

Results

Responses were received from 71 staff (51%). The frequency with which skills were used by ward staff and their self-reported confidence are displayed in Table 1.

Table 1

Discussion

Apart from ECG monitoring and airway suction, respondents performed the remaining interventions infrequently. Lack of knowledge, confidence and competence in performing a skill may lead to a reluctance to perform that skill. Similarly, infrequent opportunities to practice a skill can lead to low levels of confidence. A self-sustaining vicious circle of low utilisation and poor confidence can then be generated. Following the results of the initial questionnaire, the Outreach Team implemented a variety of educational activities including a Critical Care Skills Day and the multidisciplinary ALERT course in order to address the low levels of confidence among ward staff. Access to work-based education and training is essential for ward nurses in ensuring they are competent to assess and manage acutely ill patients who are at risk of deterioration. Further work to evaluate the impact of this educational package is now required.

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Quinton, S., Higgins, Y. Critical care training needs analysis for ward staff. Crit Care 7 (Suppl 2), P239 (2003). https://doi.org/10.1186/cc2128

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  • DOI: https://doi.org/10.1186/cc2128

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