Effect of Simulation-Based Training on the Self-Confidence of New Nurses in the Care of Patients With Acute Deterioration and Activation of the Rapid Response Team.

Background: New nurses report feeling unprepared and having low levels of self-confidence. High-fidelity simulation (HFS) is frequently used to increase confidence and improve patient safety. This study assessed whether HFS training increased new nurses' self-confidence and activation of the rapid response team (RRT) when caring for patients with clinical deterioration.

Method: A quality improvement design was used. New nurses on two units at a Level I trauma center completed a 70-minute HFS. The change in self-confidence was measured by Grundy's C-Scale, and the change in percentage of staff-initiated RRT calls versus auto-triggered calls was calculated 3 months after HFS.

Results: All 12 nurses who participated in the HFS showed improved self-confidence immediately after simulation. A Wilcox-on signed-rank paired data test showed statistically significantly improved confidence scores for all five items of the C-Scale from preintervention to immediately postintervention as well as 5 months later. One unit showed an increase in percentage of staff-initiated RRT calls 3 months postsimulation, and the other unit showed a decline in staff-initiated versus auto-triggered RRT calls.

Discussion: The HFS increased self-confidence scores from preintervention to immediately postintervention, with the increase sustained 5 months later. However, how this increase translated into practice when activating RRT calls cannot be determined because many factors can influence RRT call patterns.

Conclusion: The literature review and study results suggest that HFS training embedded into an existing nurse residency program can build self-confidence in caring for patients with clinical deterioration. .