Summer camp mock codes: studying effects on nursing self-efficacy with medical emergencies

Jessica Bhullar1*, Fuad Alnaji1, Shelley Clarke2, and Sarah Lawrence1.

1Pediatrics, University of Ottawa, and 2School of Health and Community Studies, Nursing Department, Algonquin College

PO.ID11-3

1. Hashikawa AN, Newton MF, Cunningham RM, Stevens MW. Unintentional injuries in child care centers in the United States: a systematic review. J Child Health Care. 2015 Mar;19(1):93-105. PubMed PMID: 24092867. 2. American Academy of Camps. Healthy Child Camp Study- Impact Report 2006-2010. [Internet]. American Camp Association; 2014 [cited 2016 Jan 30]. Available from: http://www.acacamps.org/sites/default/files/downloads/Healthy-Camp-Study-Impact Report.pdf 3. Olympia RP, Hollern K, Armstrong C, Adedayo P, Dunnick J, Hartley J, Doshi B. Compliance of camps in the United States with guidelines for health and safety practices. Pediatr Emerg Care. 2015 Mar;31(3):178-85. PubMed PMID: 25706923. 4. Franklin, AE, and Lee, CS. Effectiveness of Simulation for Improvement of Self-Efficacy Among Novice Nurses: A meta-analysis. J Nurs Educ. 2014 Nov;53(11):607-614. PubMed PMID: 25350902. 5. Hayden JK, Smiley RA, Alexander M, Kardong-Edgren S, and Jeffries PR. The NCSBN National Simulation Study: A Longitudinal, Randomized, Controlled Study Replacing Clinical Hours with Simulation in Prelicensure Nursing Education. J Nurs Reg. 2015;6(3):39-42. 6. Andreatta P, Saxton E, Thompson M, Annich G. Simulation-based mock codes significantly correlate with improved pediatric patient cardiopulmonary arrest survival rates. Pediatr Crit Care Med. 2011 Jan;12(1):33-8. PubMed PMID: 20581734. 7. Kennedy E, Murphy GT, Misener RM, Alder R. Development and Psychometric Assessment of the Nursing Competence Self-Efficacy Scale. J Nurs Educ. 2015;54(10):550-58. PubMed PMID: 26431514.

•  Prospective study •  Pre- and post-intervention surveys •  Surveys were modified from the Nursing

Competence Self-Efficacy Scale7 and included a 1 to 9 scale per question

•  Surveys assessed primary outcomes: confidence to respond to medical emergencies, cope with the stresses of medical emergencies, and complete overall resuscitative tasks

•  12 nursing staff, across 4 camps, completed the curriculum from July-August 2016

•  Each camp completed 4 mock codes: anaphylaxis, seizure, asthma, head injury

•  Physician and research team delegates evaluated each code, and facilitated its debriefing, via mock code specific checklists and a study debriefing script

Primary Study Objective: •  To examine if implementation of the summer

camp mock code curriculum alters nursing staff’s self-efficacy with medical emergencies.

Secondary Study Objective: •  To assess if the camp mock code curriculum

leads to more completion of standard team resuscitative tasks and skills outlined on each mock code’s checklist over time.

•  Thousands of children attend summer camps in Ontario, Canada

•  Rates of illness and injury are similar to other child-centered institutions1

•  There is a real possibility for medical emergencies

•  The Ontario Camps Association and American Camp Association emphasize training in medical care is imperative and interventions require being put into practice2

•  Many camps have medical protocols3 but the practice of these is largely unstudied and known to vary

We thank the Children’s Hospital of Eastern Ontario Research Institute, Ken Tang and colleagues from the Clinical Research Unit, Dr. Terry Varshney, and Dr. Hilary Writer.

•  All summer camp health care teams require medical emergency training and opportunities to rehearse their response

•  The innovative Summer Camp Emergency Program, utilizing a mock code curriculum, improved nursing self-efficacy related to pediatric medical emergencies

•  This novel program is one tool that may help address gaps in current camp care

•  Future studies should further document summer camp emergency epidemiology and gaps in emergency preparedness

•  This study opens the doors to further research into simulation at summer camps and the possibility of a low fidelity simulation program across camps on a larger scale

Introduction

Methods

Results

9th International Pediatric Simulation Symposium and Workshops 2017

1-3 June, Boston, MA, USA

Study Objectives

Conclusions

References

Curriculum Purpose

Acknowledgements

Contact:jbhullar@cheo.on.ca

The Summer Camp Emergency Program, a mock code curriculum, was created to help address gaps in camp emergency preparedness as simulation and mock codes are known to improve nursing self-efficacy4,5, knowledge and skills6.

Primary Objective: •  Data from pre- and post-intervention surveys

were analyzed via a two-sided paired t-test using a confidence interval of 95%

Table 1: Study outcomes

* Responses correlate to average responses to 9 separate resuscitative tasks on surveys. Comments From Surveys: •  “helped build confidence in an emergent

situation” •  “used knowledge gained during first mock

drills in situations that arose afterwards” Secondary Objective: Figure 1: Camp team mock code performance over time Figure 2: A low fidelity summer camp mock code at the original camp that inspired the Summer Camp Emergency Program study.

Howconfidentareyouthatyoucan:

AveragePre-Study

AveragePost-Study

p-value

Respondappropriatelytoacampermedicalemergency

5.75 7.75 0.000005

Copewiththestressofamedicalemergency

6.08 7.75 0.002

CompleteresuscitaHvetasks*

6.31 7.96 0.0001