Doctoral Project Defense: Natalia Pascual
Candidate: Natalia Pascual
Major: Doctor of Nursing Practice
Advisor: Lori Brien, D.N.P.
Title: eLearning and Mobility: An Electronic Education to Evaluate SICU RN Knowledge and Adherence to an Institution-Specific Mobility Protocol
Clinical practice guidelines (CPGs) are systemic evidence-based recommendations devised to assist healthcare workers standardize and improve patient care quality. Despite CPG’s ability to bridge evidence to practice, adherence occurs only 36% of the time. A barrier to CPG uptake is a lack of formal education and training. Evidence indicates that consistent education, specifically electronic, can improve care practices and patient outcomes. Therefore, the aim of this QI project was to evaluate the effect of an eLearning education on SICU RN knowledge and adherence to an institution-specific mobility protocol.
This project was conducted on a 24-bed SICU within a large urban tertiary care center. A pre-post design was used to assess both knowledge and adherence outcomes. Baseline adherence and knowledge assessments occurred over a six- and two-week period, respectively. After gathering baseline data, an eLearning educational module on the PUMP Plus© mobility guidelines was distributed to SICU RNs and completed over a two-week period using the site’s continuing education server. Following the eLearning intervention, adherence and knowledge were evaluated again over identical six- and two-week periods. Adherence data was collected via SICU RN charting in the medical record. Knowledge data was collected using Qualtrics administered assessments.
A total of npre=950 and npost=882 patient encounters were evaluated between the pre and post period to assess adherence rates. Using a Z-test of proportions, a statistically significant increase in the proportion of encounters that met adherence was seen, from 47.6% pre to 59.2% post, p < .001. Of the eligible SICU RNs, N=10 completed both the pre and post knowledge assessments for data analysis. Using a paired samples t-test, the percentage of correct knowledge assessment scores from pre (43.6%) to post (68.2%) was statistically significant, p < .001, but underpowered. During the two-week intervention period, 49.1% of SICU RNs completed the eLearning education.
Overall, this project found an increase in both SICU RN knowledge and adherence to the PUMP Plus© mobility guidelines as a result of an eLearning education. These results reveal that this eLearning education may be effective for use beyond the SICU and expandable to the entire implementation site.