Effectiveness of virtual reality training in improving knowledge among nursing students: A systematic review, meta-analysis and meta-regression.

OBJECTIVES: We aimed to (1) evaluate the effectiveness of virtual reality (VR) training in improving knowledge among nursing students and (2) identify the essential features of training. DESIGN: This systematic review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. DATA SOURCES: Randomised controlled trials (RCTs) were obtained from PubMed, EMBASE, Cochrane Library, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, ProQuest and Scopus databases from inception up until 15 October 2019. REVIEW METHODS: Meta-analysis and random-effects meta-regression was performed using the Comprehensive Meta-analysis 3.0 software. The overall effect was measured using Hedges' g and determined using Z-statistics at the significance level of p < 0.05. Heterogeneity was assessed using χ2 and I2 statistics. The risk of bias tool and the Grading of the Recommendation, Assessment, Development and Evaluation (GRADE) system were employed to assess individual and overall quality of evidence, respectively. RESULTS: Among the 1993 records identified, 14 trials were included. Meta-analysis demonstrated a significant improvement in knowledge, with a small-to-medium effect (g = 0.47) in the VR group compared to the control group (Z = 2.66, p = 0.01). Subgroup analyses highlighted that VR training was more efficacious in delivering procedural knowledge to undergraduate nursing students when conducted in multiple, self-guided, short sessions within 30 min and by using low-moderate level of immersion. Meta-regression did not detect significant covariates that influenced knowledge scores. CONCLUSIONS: Virtual reality may be a viable teaching strategy to improve knowledge acquisition, but it is presently suitable for supplementing conventional teaching methods. Nonetheless, VR could complement current pedagogy to address challenges associated with decreased clinical placement opportunities. Larger, well-designed RCTs are required to strengthen the evidence about the effectiveness of VR training.

A cross-sectional survey on nurses' second victim experience and quality of support resources in Singapore.

AIM: The study aimed to investigate nurses' second victim experience and quality of support resources in Singapore. BACKGROUND: The second victim phenomenon, broadly described as the suffering of providers including nurses in the face of a clinical error, is often overlooked. METHODS: A cross-sectional questionnaire survey was adopted. A total of 1,163 nurses from an acute public hospital in Singapore took part in the study. The Second Victim Experience and Support Tool (SVEST) was employed to assess experience of second victims and the quality of support resources. RESULTS: The study results showed that nurses experienced second victim-related physical, psychological and professional distress. About 31.8% of the participants had turnover intentions, while 9.3% had absenteeism following an error. Nurses who are younger and less experienced were more likely to experience greater second victim response. Among the support options, peer support was rated as the most desirable. CONCLUSION: Nurses, being at the forefront of care delivery, are especially susceptible to being a casualty of the second victim phenomenon. IMPLICATIONS FOR NURSING MANAGEMENT: Acknowledging the second victim phenomenon, together with a strong organizational support, is essential in alleviating the trauma and assisting nurses with reconciliation in the aftermath of an unanticipated error.

An integrative care bundle to prevent surgical site infections among surgical hip patients: A retrospective cohort study.

BACKGROUND: Surgical site infections (SSIs) following hip fracture surgeries have profound clinical and economic implications. The study aims to analyze the effect of an integrative SSI prevention care bundle on the SSI incidence among surgical hip patients. The study also aims to examine the association between SSI and mortality, readmission, duration of hospitalization, and hospital cost. METHODS: A retrospective cohort study was carried out to assess the incidence of SSI in an acute hip unit in Singapore from January 2015 to September 2017. Patients who developed SSI fell into the exposure group, whereas patients without SSI fell into the nonexposure group. A comparison of the incidence of mortality, readmission, length of stay, and inpatient bill size was conducted between the 2 groups. RESULTS: Among 758 hip surgeries performed during the study period, 14 (1.8%) SSIs were documented. Compared with patients with no SSI, patients with SSI were 4.27times more likely to be readmitted within 30days, had 2.47times longer length of stay, and 2.15times the inpatient bill size. CONCLUSIONS: An integrative care bundle that capitalizes on the expertise of a multidisciplinary team has promoted shared responsibility and proven to be effective in preventing SSIs while contributing to better patient outcomes within the unit.

Vital signs monitoring to detect patient deterioration: An integrative literature review.

Vital signs monitoring is an important nursing assessment. Yet, nurses seem to be doing it as part of a routine and often overlooking their significance in detecting patient deterioration. An integrative literature review was conducted to explore factors surrounding ward nursing practice of vital signs monitoring in detecting and reporting deterioration. Twenty papers were included. The structural component of a Nursing Role Effectiveness Model framework, which comprises of patient, nurse and organizational variables, was used to synthesize the review. Patient variables include signs of deterioration displayed by patients which include physical cues and abnormal vital signs. Nursing variables include clinical knowledge, roles and responsibilities, and reporting of deteriorating vital signs. Organizational variables include heavy workload, technology, and observation chart design. This review has highlighted current nursing practice in vital signs monitoring. A myriad of factors were found to surround ward practice of vital signs monitoring in detecting and reporting deterioration.