Buy Guide
Twitter

Palliative care emergencies in a hospice setting: A simulation-based training programme to improve confidence and competence of nursing and allied health professionals

Background and Objectives

Simulation-based training has gained recognition as an effective educational tool in both medical and nursing education. However, its application in palliative care has been largely restricted to enhancing communication skills. Given the relative rarity of clinical emergencies in hospice settings, relying exclusively on real-world practice for the development of competency is impractical. Existing evidence supports the successful translation of skills acquired through simulation into clinical practice, making it a valuable approach for training healthcare professionals in palliative care. This project aimed to design and implement a simulation-based training programme for nursing and allied healthcare professionals, with the goal of enhancing their ability to recognise and manage clinical emergencies within a hospice context.

The objectives were as follows:

  • To design and implement a simulation-based training programme targeting palliative care emergencies in a hospice environment.
  • To evaluate the programme’s impact on self-reported confidence and competence.
  • To assess the programme’s effectiveness in improving objective clinical performance, as evaluated through serial Objective Structured Clinical Examinations (OSCEs).
Method

The developed training programme was tailored to nursing and allied healthcare professionals, enabling them to practice essential clinical skills for managing palliative care emergencies. Topics covered included opioid toxicity, catastrophic hemorrhage, status epilepticus, anaphylaxis, hypoglycemia, and airway obstruction. During the initial phase, eight training sessions were conducted. A pre- and post-questionnaire design was employed to assess participants' self-reported confidence and perceived competence in managing these emergencies, both before and after each simulation. Participants also provided qualitative feedback through open-ended questions. Statistical analysis was conducted using paired t-tests to determine any significant changes in competence and confidence scores, while free-text responses were analysed thematically.

In the first phase of the programme, self-reported confidence and competence served as the primary outcome measures. In the second phase, the focus shifted to objective performance measures. In this phase, participants underwent an OSCE both before and after the training session, with evaluations conducted by two independent members of the hospice medical team. Analysis of the data from this phase is currently underway.

Results

The initial phase of the programme demonstrated a statistically significant increase in both confidence and competence scores when comparing pre- and post-training assessments. Participants expressed appreciation for the opportunity to hone their emergency response skills and recognised the value of simulation-based learning. The debriefing component of the training was particularly emphasised as a crucial element for reinforcing learning and encouraging self-reflection.

Conclusion

Participation in simulation-based training designed for palliative care emergencies in a hospice setting led to significant improvements in both the confidence and perceived competence of nursing and allied healthcare professionals. The ongoing second phase of the programme, which evaluates objective clinical performance, is expected to provide further insights into the effectiveness of simulation training in this context, with results anticipated in the near future.

Details
Project Type

You May Also Be Interested In

  • Palliative Care Guidance
  • Research Projects
  • Education & Events