Periferal intravenöz kateterizasyon uygulama becerisi geliştirmede ve intravenöz sıvı tedavi komplikasyonlarını tanılamada hibrit simülasyon kullanımının etkisi
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Tarih
2017
Yazarlar
Dergi Başlığı
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Cilt Başlığı
Yayıncı
Ege Üniversitesi, Sağlık Bilimleri Enstitüsü
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Araştırma, hemşirelik öğrencilerinde periferal intravenöz kateterizasyon (PİK) becerisi geliştirmede ve intravenöz (İV) sıvı tedavi komplikasyonlarını tanılamada hibrit simülasyon kullanımının etkisinin incelenmesi amacıyla randomize kontrollü yarı deneysel olarak gerçekleştirilmiştir. Araştırma, İzmir Kâtip Çelebi Üniversitesi'nde Şubat- Haziran 2016 tarihleri arasında yürütülmüştür. Araştırmanın evrenini 2015-2016 Öğretim Yılı'nda Hemşirelik Esasları Dersi'ne kayıtlı 171 öğrenci oluşturmuştur. Örneklem seçiminde tabakalı rastgele örnekleme yöntemi kullanılmış; deney ve kontrol grubunda 33 öğrenci olmak üzere toplam 66 öğrenci örnekleme dâhil edilmiş, araştırma deney ve kontrol grubunda 31 öğrenci olmak üzere 62 öğrenci ile tamamlanmıştır. Verilerin toplanmasında; deney grubu hibrit simülasyon (standardize hasta+ mulaj), kontrol grubu ise düşük gerçekli simülasyon (düşük gerçekli manken+ İV sıvı tedavi komplikasyonları görselleri) ile simülasyon uygulamasını gerçekleştirmiştir. Simülasyon uygulamasının ardından "Öğrenmede Öğrenci Memnuniyeti ve Özgüven Ölçeği ile "Simülasyon Tasarım Ölçeği" uygulanmıştır. Performans değerlendirmede öğrencilerin psikomotor beceri ve klinik psikomotor beceri düzeyleri değerlendirilmiştir. Verilerin değerlendirilmesinde sayı ve yüzdelik dağılımlar, Bağımsız gruplar t Testi, Mann-Whitney U testi, Wilcoxon testi ve Kikare analizi kullanılmıştır. Araştırmanın uygulanabilmesi için etik kurul izni, kurum izni ve araştırmaya katılmayı kabul eden öğrencilerden, standardize hastalardan ve öğretim elemanlarından yazılı izin alınmıştır. Araştırma sonucunda; Deney grubu (60.96±19.38) ve kontrol grubunda (60.64±21.89) simülasyon eğitimi öncesi PİK bilgi ön test puan ortalamaları açısından istatistiksel olarak anlamlı bir fark saptanmamış; simülasyon eğitimi sonrası deney grubu (82.96±15.53) ve kontrol grubunda (68.70±20.61) PİK bilgi son test puan ortalamaları açısından iki grup arasında istatistiksel olarak anlamlı bir fark saptanmıştır (p>0.05; p<0.001). Deney grubu (50.56±23.44) ve kontrol grubunda (51.20±24.01) simülasyon eğitimi öncesi İV sıvı tedavi komplikasyonları bilgi ön test puan ortalamaları açısından istatistiksel olarak anlamlı bir fark saptanmamış; deney grubu (75.00±15.13) ve kontrol grubunda (58.06±21.05) simülasyon eğitimi sonrası İV sıvı tedavi komplikasyonları bilgi son test puan ortalamaları açısından iki grup arasında istatistiksel olarak anlamlı bir fark saptanmıştır (p>0.05; p<0.001). Deney grubunda "Öğrenmede Öğrenci Memnuniyeti ve Özgüven Ölçeği" toplam madde puan ortalamalarının (4.67±0.33) kontrol grubu puan ortalamalarından (4.24±5.54) yüksek olduğu belirlenmiş ve arasındaki farkın istatistiksel olarak anlamlı olduğu bulunmuştur (p<0.001). Deney grubunda "Simülasyon Tasarım Ölçeği" toplam madde puan ortalamalarının (4.63±0.43;4.60±0.39) kontrol grubu puan ortalamalarından (4.49±0.35;4.54±0.34) yüksek olduğu belirlenmiş, arasındaki fark istatistiksel olarak anlamlı bulunmamıştır (p>0.05).Deney (41.17±3.21) ve kontrol grubunda (35.54±4.13) PİK beceri performans puan ortalamaları arasında; deney (43.91±2.08) ve kontrol grubunda (37.90±4.75) gerçek hastada PİK beceri uygulama puan ortalamaları arasında iki grup arasında istatistiksel olarak anlamlı bir fark saptanmıştır (p<0.001; p<0.001). Deney (%71) ve kontrol (%45.2) grubu öğrencilerinin İV sıvı tedavi komplikasyonunu tanılama durumları açısından ve deney (%93.5) ve kontrol (%29) grubu öğrencilerinin gerçek hastada İV sıvı tedavi komplikasyonunu tanılama durumları açısından iki grup arasında istatistiksel olarak anlamlı bir fark saptanmıştır (p<0.05; p<0.05).Deney grubu öğrencileri, standardize hasta ile çalışmanın öğrenmelerini olumlu etkileyerek hasta ile iletişimini kolaylaştırdığını ifade etmiş, ayrıca mulaj yapılmış kol maketi ile çalışmış olmanın hafızalarında kalıcılık sağladığını, bu nedenle gerçek hasta üzerinde komplikasyonu tanılarken zorluk yaşamadıklarını ifade etmişlerdir. Araştırma sonucunda hemşirelik eğitiminde periferal intravenöz kateterizasyon uygulama becerisi geliştirmede ve intravenöz sıvı tedavi komplikasyonlarını tanılamada hibrit simülasyon kullanımının etkili olduğu saptanmıştır.
This study was conducted as randomized controlled and quasi-experimental to investigate the effect of hybrid simulations on the development of peripheral intravenous catheterization (PIC) skills of nursing students and to diagnose intravenous (IV) fluid treatment complications. The study was conducted in İzmir Kâtip Çelebi University between February and June, 2016. Population of the research consisted of 171 students who were studying in the first-grade of Nursing Fundamentals Course in the 2015-2016 academic year. A stratified random sampling method was used in the selection of samples; A total of 66 students were included in the study as 33 for each experimental and control group, and the study was completed with a total of 62 students as 31 for control and experimental groups. In the collection of the data; the experimental group performed the simulation with hybrid simulation (standardized patient + moulage) and the control group performed the simulation with low fidelity simulation (manikin + images of IV fluid treatment complications). After the simulation practice, "Student Satisfaction and Self-Confidence in Learning Scale" and "Simulation Design Scale" were applied. Levels of psychomotor skills and clinical psychomotor skills of the students were evaluated in performance assessment progress. In the analysis of the data, number and percentage distributions, independent groups t-test, Mann-Whitney U test, Wilcoxon test and Chi-Square analysis were used. In order to be able to conduct this research, approval of ethical review board and institution, and the written permissions of students who accepted to participate in the study, the standardized patients and the faculty members were taken. As a result of the research; There was no statistically significant difference between PIC information pre-test mean score of control group (60.96±19.38) and experimental group (60.64±21.89) before the simulation training; after the training, in terms of PIC information post-test mean scores, there was a statistically significant difference found between experimental (82.96±15.53) and control (68.70±20.61) groups (p>0.05; p<0.001). In terms of IV fluid complications information pre-test mean scores, there was no statistically significant difference found between experimental (50.56±23.44) and control (51.20±24.01) groups; after the simulation training, in terms of IV fluid complications information post-test mean scores, there was a statistically significant difference between the experimental (75.00±15.13) and control (58.06±21.05) groups (p>0.05; p<0.001). In experimental group, it was determined that "Student Satisfaction and Self-Confidence in Learning Scale" total mean score (4.67±0.33) were higher than the control group's total mean score (4.24±5.54) and the difference between the scores was found to be statistically significant (p<0.001). In experimental group, it was determined that "Simulation Design Scale" total mean scores (4.63±0.43;4.60±0.39) was higher than control group's mean scores (4.49±0.35;4.54±0.34), however the difference was not found as statistically significant (p>0.05). In terms of mean scores of the PIC skill performance scores of experimental (41.17±3.21) and control group (35.54±4.13); there was a statistically significance found between PIC skill application on real patient scores of experimental (43.91±2.08) and control group (37.90±4.75) (p<0.001; p<0.001). In terms of diagnosis status of IV fluid complications of experimental (71%) and control (45.2%) group students and diagnosis status of IV fluid complications on real patient of experimental (93.5%) and control (29%), there was a statistically significant difference found between the two groups (p<0.05; p<0.05). Students from experimental group stated that working with the standardized patient facilitates communication with the real patient by positively affecting their learning, working with an moulage arm model made the knowlage retention in their memory and therefore they did not face with difficulty in diagnosis the complication on the real patient. As a result of the research, it was determined that the use of hybrid simulation was effective in development the skills of peripheral intravenous catheterization in nursing education and in diagnosis of intravenous fluid therapy complications.
This study was conducted as randomized controlled and quasi-experimental to investigate the effect of hybrid simulations on the development of peripheral intravenous catheterization (PIC) skills of nursing students and to diagnose intravenous (IV) fluid treatment complications. The study was conducted in İzmir Kâtip Çelebi University between February and June, 2016. Population of the research consisted of 171 students who were studying in the first-grade of Nursing Fundamentals Course in the 2015-2016 academic year. A stratified random sampling method was used in the selection of samples; A total of 66 students were included in the study as 33 for each experimental and control group, and the study was completed with a total of 62 students as 31 for control and experimental groups. In the collection of the data; the experimental group performed the simulation with hybrid simulation (standardized patient + moulage) and the control group performed the simulation with low fidelity simulation (manikin + images of IV fluid treatment complications). After the simulation practice, "Student Satisfaction and Self-Confidence in Learning Scale" and "Simulation Design Scale" were applied. Levels of psychomotor skills and clinical psychomotor skills of the students were evaluated in performance assessment progress. In the analysis of the data, number and percentage distributions, independent groups t-test, Mann-Whitney U test, Wilcoxon test and Chi-Square analysis were used. In order to be able to conduct this research, approval of ethical review board and institution, and the written permissions of students who accepted to participate in the study, the standardized patients and the faculty members were taken. As a result of the research; There was no statistically significant difference between PIC information pre-test mean score of control group (60.96±19.38) and experimental group (60.64±21.89) before the simulation training; after the training, in terms of PIC information post-test mean scores, there was a statistically significant difference found between experimental (82.96±15.53) and control (68.70±20.61) groups (p>0.05; p<0.001). In terms of IV fluid complications information pre-test mean scores, there was no statistically significant difference found between experimental (50.56±23.44) and control (51.20±24.01) groups; after the simulation training, in terms of IV fluid complications information post-test mean scores, there was a statistically significant difference between the experimental (75.00±15.13) and control (58.06±21.05) groups (p>0.05; p<0.001). In experimental group, it was determined that "Student Satisfaction and Self-Confidence in Learning Scale" total mean score (4.67±0.33) were higher than the control group's total mean score (4.24±5.54) and the difference between the scores was found to be statistically significant (p<0.001). In experimental group, it was determined that "Simulation Design Scale" total mean scores (4.63±0.43;4.60±0.39) was higher than control group's mean scores (4.49±0.35;4.54±0.34), however the difference was not found as statistically significant (p>0.05). In terms of mean scores of the PIC skill performance scores of experimental (41.17±3.21) and control group (35.54±4.13); there was a statistically significance found between PIC skill application on real patient scores of experimental (43.91±2.08) and control group (37.90±4.75) (p<0.001; p<0.001). In terms of diagnosis status of IV fluid complications of experimental (71%) and control (45.2%) group students and diagnosis status of IV fluid complications on real patient of experimental (93.5%) and control (29%), there was a statistically significant difference found between the two groups (p<0.05; p<0.05). Students from experimental group stated that working with the standardized patient facilitates communication with the real patient by positively affecting their learning, working with an moulage arm model made the knowlage retention in their memory and therefore they did not face with difficulty in diagnosis the complication on the real patient. As a result of the research, it was determined that the use of hybrid simulation was effective in development the skills of peripheral intravenous catheterization in nursing education and in diagnosis of intravenous fluid therapy complications.
Açıklama
Anahtar Kelimeler
Hemşirelik Eğitimi, Hibrit Simülasyon, Intravenöz Sıvı Tedavi Komplikasyonları, Periferal Intravenöz Kateterizasyon, Nursing Education, Hybrid Simulation, Intravenous Fluid Therapy Complications, Peripheral Intravenous Catheterization
