Simulation-Based Mastery Learning for Central Venous Line Dressing Changes

• Published in: Clinical simulation in nursing 2019-02, Vol.27, p.35-38
• Main Authors: Dahlen, Brittany, Finch, Michael, Lambton, Judith
• Format: Article
• Language: English
• Subjects: central line maintenance; competency training; nursing; pediatric; simulation mastery; simulation-based mastery learning
• ISSN: 1876-1399; 1876-1402
• DOI: 10.1016/j.ecns.2018.10.010

The aim of this study was to determine the effectiveness of simulation-based mastery learning (SBML) for competency training with pediatric cardiac intensive care (CVICU) nurses in central venous line (CVL) dressing changes. Convenience sample of 20 CVICU nurses at a freestanding Midwestern pediatric hospital. Content experts developed curricula, created checklists and set a minimum passing score (MPS) for CVL dressing procedure. Participants were scored via direct observation by two trained raters and were tested before SBML intervention to measure pretest score. Debriefing was provided after attempts until mastery was achieved. None of the participants achieved MPS in the pretest. Common missteps include maintaining sterile protocol and masking the patient. MPS was achieved by 55% in the second attempt and 89% in the third attempt. The SBML intervention was effective in achieving a predetermined mastery level in CVL dressing changes with pediatric CVICU nurses. •SBML may lead to improved nurse performance in central line dressing changes.•None of the participants met minimum passing score in pretest.•Self-rated confidence is not predictive of performance in central line cares.