Pre-Operative High-Fidelity Simulation Education for Veterans

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Primary Author:</td>
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Bonnie Haupt, DNP (c), MSN, RN, CNL, CHSE</td>
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Co-Principal Investigators/Collaborators:</td>
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N/A</td>
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Organization:</td>
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VA Connecticut Healthcare System</td>
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Abstract</h2>
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Purpose</h3>
<p>The study aimed to evaluate the influence of simulation education on Veterans undergoing Coronary Artery Bypass Graft (CABG) surgeries knowledge, satisfaction, anxiety, and length of stay. </p>
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Background</h3>
<p>Coronary Artery Bypass Graft surgery accounts for the largest number of open heart surgeries performed in the United States (U.S. Department of Health and Human Services [USDHHS], 2011). Patients receiving CABG surgeries have expressed anxieties in the post-operative period over lack of complete understandings of post-operative care and expectations. In 2006, The Joint Commission (TJC) mandated that each patient receive education specific to their care and treatment; however, few facilities have focused on various educational methods. Most educational experiences for patients have included verbal and written handouts. It has been identified that an absence of diverse teaching methods can lead to a lack of patient understanding (Hahn, Fish, Dunn & Halperin, 2005; Harless et al., 2009; Kolb, 1984; Mikulaninec, 1987). Studies have shown poor outcomes in surgical patients related to patient anxiety levels and that the average patient receiving any form of pre-operative instruction had more favorable outcomes (Brunges & Avigone, 2003; Pignay-Demaria, Lesperance, Demaria, Frasure-Smith, & Perrault, 2003; Shuldham, 2001). </p>
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Materials & Methods</h3>
<p>An experimental pre and post test design was used with 20 Veterans scheduled to receive CABG surgery. </p>
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Results</h3>
<p>There was no significant improvement in length of stay in Veterans in either educational group. However, use of a high-fidelity simulation education intervention experience revealed a significant increase in Veteran knowledge group (t (10.25) = 7.09, p = .0001, d=3.19) and satisfaction (9.24) = 2.66, p = .03, d=1.20) compared to the control usual pre-CABG education sessions. Veterans also had a significant decrease in State anxiety scores in the intervention simulation education group over the control usual pre-CABG groups (t (18) = -2.61, p = .02, d=1.17). </p>
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Conclusion</h3>
<p>Simulation education is an effective educational tool for education CABG patients pre-operatively. The findings of the study indicate a benefit to Veteran knowledge, satisfaction and anxiety levels when utilizing high-fidelity simulation education. </p>
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Bibliography</h3>
<ul>
<li>
Brunges, M., & Avigne, G. (2003). Music therapy for reducing surgical anxiety. AORN Journal, 78, 816–818.</li>
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Hahn, C. A., Fish, L. J., Dunn, R. H., & Halperin, E. C. (2005). Prospective trial of a video educational tool for radiation oncology patients. American Journal of Clinical Oncology, 28(6), 609–612.</li>
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Harless, W. G., Zier, M. A., Harless, M. G., Duncan, R. C., Braun, M. A., Willey, S., & Warren, R. D. (2005). Evaluation of virtual dialogue method for breast cancer patient education. Patient Education and Counseling, 76, 189–195.</li>
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The Joint Commission. (2006). Comprehensive accreditation manual for hospitals. Oak Book Terrace, IL: Author.</li>
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Kolb D. (1984). Experiential learning: Experience as the source of learning and development. Englewood Cliffs, NJ: Prentice Hall.</li>
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Mikulaninec, C. E. (1987). Effects of mailed preoperative instructions on learning and anxiety. Patient Education and Counseling, 10, 253–265.</li>
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Pignay-Demaria, V., Lesperance, F., Demaria, R, G., Frasure-Smith, N., & Perrault, L. P. (2003). Depression and anxiety and outcomes of coronary artery bypass surgery. Annals of Thoracic Surgery, 75, 314–321.</li>
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Shuldham, C. M. (2001). Pre-operative education for the patient having coronary artery bypass surgery. Patient Education and Counseling, 43(2), 129–137.</li>
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U.S. Department of Health and Human Services. (2011). National Heart, Lung and Blood Institute. Washington DC. Retrieved from http://www.nhlbi.nih.gov/health/health-topics/topics/hs/</li>
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<p>© Improvement Science Research Network, 2012</p>
<p>The ISRN published this as received and with permission from the author(s).</p>