Advancing Support for Bronchiolitis Patients in Rural Communities With Simulation Training

Annually, bronchiolitis impacts 40% of children under 2 years of age. Acute respiratory failure (ARF) is a significant concern for pediatric patients who present with bronchiolitis. When response times are delayed or patients receive inappropriate interventions, ARF can lead to poor outcomes and higher mortality. Nurses who do not routinely care for high-acuity pediatric patients feel unprepared to care for them when they develop ARF. This quality improvement project aimed to improve nurse (RN) readiness when caring for pediatric patients experiencing ARF in a rural community hospital. We evaluated the standard of care and measured change to R.N. self-efficacy longitudinally with training in the bronchiolitis disease process, a predictive respiratory status score (ROX), and standard communication strategies (SBAR). Using a standardized and validated basic resuscitation skills self-efficacy scale, two-tailed Wilcoxon signed rank tests and two-tailed paired samples t-tests were analyzed and identified a significant change in pre-post intervention self-efficacy for assessment of the patient condition with alpha value of 0.05, V=6.50, z=-2.14, p=0.032, factor 2, Resuscitation actions with alpha value of 0.05, V=6.50, z=-2.14, p=0.032, and employment of defibrillation with alpha value of 0.05, V=5.50, z=-2.45, p=0.014. Using a tiered skill acquisition model with simulation training, ROX scoring, and SBAR training improved nurse self-efficacy for caring for patients experiencing respiratory decompensation.