Grant: Travel Awards - Institute Community Support

Unintended effects of epidural analgesia, including: insufficient analgesia, excessive sensory or motor block, and hematoma have been reported. Registered Nurses (RN's) receive didactic training regarding care of patients receiving epidural analgesia. Although RN's are tested on their knowledge, their ability to critically think through adverse events is not assessed. Human patient simulation provides a unique opportunity for nurses to practice and reflect on assessments in a simulated setting based on real patient cases. The aim of this study was to fill a gap in RN's knowledge of the care of patients receiving epidural analgesia through the use of simulation education. The ultimate goal was to improve the quality of care and patient safety.  The study included an 4-hour workshop and 2 Objective Structured Clinical Examinations (OSCE). Workshops were led by an expert nurse practitioner. Content of the workshop was developed based on data from RN's documentation in electronic health records and it included care and assessment of side effects in patients receiving epidural analgesia for pain management after surgery. After obtaining informed consent RN's completed an OSCE where they demonstrated an assessment of a patient receiving epidural analgesia on a standardized patient and electronic documentation of the assessment. RN's then completed a knowledge questionnaire followed by a lecture and demonstration of care of patients who are receiving epidural analgesia. Following the lecture, RN's practiced the assessment. A post-workshop OSCE, and questionnaire was completed at the end of the workshop. Thirty-seven RN's completed the study. There was a significant improvement in 8/21 questions for the pre & post knowledge questionnaire. Improvements in answers on the questionnaire were related to pharmacology. For the pre & post OSCE, there was a significant increase in the number of correct procedures performed and reported confidence of RN's in providing care.