Development and Evaluation of a Metric-based Clinical Simulation Procedure for Assessing Ostomy Care in Nursing Practice.

ABSTRACT

Background: There is a need to understand the clinical decision-making and work practices within ostomy nursing care to support expanding nursing training. Objective: To develop and evaluate a new metric-based simulation for assessing ostomy nursing care using a human factors approach. Sample This pilot study involved eleven stakeholders in the needs assessment, six nurse participants performing simulated ostomy care, and three independent observers assessing procedure reliability. Method: We conducted a needs assessment of ostomy nursing care and training, developed an enhanced metric-based simulation for ostomy appliance change procedures, and statistically evaluated its reliability for measuring the simulated tasks. Results: The enhanced metric-based simulation captured different tasks within four task categories product selection; stoma and peristomal skin care; baseplate sizing and adhesion; and infection control strategies. The video review procedure was reliable for assessing continuous (average ICC≥0.96) and categorical (average κ>0.96) variables. Conclusion: The new metric-based simulation was suitable for characterizing a broad range of clinical decision-making and work practices in ostomy nursing care.