A matter of convenience

As time becomes increasingly precious, hospitals are going online to educate their staff, writes Annie May.

Chest drains remain a common intervention for patients with cardiothoracic or respiratory problems. Management of the clinical risks associated with adverse outcomes is an integral part of cardiac nurses’ roles and responsibilities.

Ensuring staff skills and knowledge are current, however, is problematic due to the logistics of traditional training workshops.

This was the situation observed by two nurses at Brisbane’s St Andrews War Memorial Hospital, which has a large cardiac program.

“Taking nurses out of the system to attend workshops causes a number of staff problems for hospitals, especially with the current nurse shortage,” says Monica Higgins.

“Ongoing education is a necessity of the job, so we have to look at ways we can provide it that is suitable, and achievable, for both management and nurses.”

Together with fellow St Andrew’s critical care nurse Diane Suddaby, Higgins researched which delivery of education worked better to improve nurses’ knowledge of chest drain management – traditional didactic education or web based self directed learning.

This involved developing an online interactive education tool.

“The use of chest drains is very common, but there is potential for adverse affects to occur and nurses need to be aware of how to indentify and manage these,” says Higgins.

“We looked at what we were currently doing at the hospital in regards to educating our nurses in this area. That included formal cardiac courses, presentations and journal club. What wasn’t on offer was an online education program.”

The program has seven chapters which range from normal lung physiology to looking at why chest drains are needed and included scenarios based on clinical best practice.

“One of the most important components of the program is that we get nurses to look at the patient first, technology second. Look to the patient for signs of improvement or worsening. Then look at the drain to check that it is working properly,” says Higgins.

Fifty-eight nurses employed in the medical, cardiothoracic and cardiology wards were recruited into either a workshop or web based education program. Knowledge of chest drain management was assessed using the results of an exam that was administered pre and post educational intervention.
Comparison of the correct answers indicated no difference in performance between the two groups of participants prior to the educational intervention and both groups improved significantly following the intervention. Participants in both groups also noted many benefits.

However, there was one major difference – convenience.

“The workshop respondents enjoyed being able to share knowledge with each other and to have questions answered immediately. But the format carried rostering problems in that it was difficult to release a number of nurses away from the ward at once to attend,” says Higgins.

“The web-based program was reported to be easily accessible and offered the flexibility for the nurses to be able to work at their own pace and go back over topics compared to the workshop.

“As the two educational approaches were equally effective in improving chest drainage knowledge, the differentiator between the two approaches is matters of convenience. Problems in taking staff offline for group workshops are a major drawback, making web based education an attractive alternative.”

For online education to be successful, hospitals will need to offer appropriate support, says Higgins. This includes teaching even the basics of using a computer

“There is a perception that in this time everyone knows how to use a computer, but this isn’t the case. There is no point having a program available if using it properly is too daunting a prospect,” she says.

“And of course, there needs to be people available to answer any questions on content or assist those who are having problems. We can’t leave it all in the hands of a computer.”

Higgins and Suddaby are looking at other cardiac topics to include in the online program.

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