Abstract
Background: Because aquapheresis is a new and highly specialized treatment modality, many nursing curricula do not teach students how to operate and trouble-shoot its equipment. In order to bridge the gap between classroom and practice, simulation-based education is now being used to increase knowledge. Therefore, the purpose of this project was to implement and evaluate a comprehensive educational program (CAEP) to improve HF knowledge and self-confidence of registered nurses (RNs) working in critical care units who provide care to patients receiving aquapheresis in a rural setting.|The research questions were: 1). Does the CAEP improve RNs’ knowledge and perceived confidence in caring for HF patients receiving aquapheresis from baseline to 4 weeks and baseline to 8 weeks post-intervention? 2.) Does the score on the Creighton Simulation Evaluation Instrument (C-SEI) reflect nurse competence on the CAEP performance?|Methods: A pre-posttest design was used with a convenience sample of RNs (N = 20). Each nurse completed a pre-CAEP and post-CAEP clinical knowledge and confidence questionnaire. Repeat tests were completed at 4 weeks and at 8 weeks post-simulation. CSEI was used to evaluate nurse competence and knowledge retention. All nurses received the highest score of 1 on 14 possible items achieving (>75%) immediately following simulation.|Results: The majority of the sample was female (n=13), 65% (n=13) had bachelor’s degrees, and nearly 60% (n=12) reported running aquapheresis therapy between 0-10 times. No CAEP knowledge results were found to be statistically significant. Statistically significant results were reported in nurses’ confidence level in both troubleshooting aquapheresis equipment (p=0.0032) with improvement of 95% (n=19) at 4 weeks and 100% (n=20) at 8 weeks and overall HF aquapheresis decision making (p=0.0036) of 85% (n=17) at 4 weeks and 100% (n=20) at 8 weeks. The Creighton Simulation Education Tool (CSEI) found all nurses (n=20) within the sample received a one on each of 14 possible items indicating competency and knowledge retention.|Conclusions: Utilizing simulation to augment continuing nursing education programs for aquapheresis may strengthen perceived nurse knowledge and confidence caring for HF patients. Further research should aim to use larger sample sizes and direct assessments of nurses’ clinical performance.