The effect of hybrid simulation on developing peripheral intravenous catheterization application skills and diagnosing intravenous fluid therapy complications

This study was conducted as randomized controlled and quasi-experimental to investigate the effect of hybrid simulations on the development of peripheral intravenous catheterization (PIC) skills of nursing students and to diagnose intravenous (IV) fluid treatment complications. The study was conducted in İzmir Kâtip Çelebi University between February and June, 2016. Population of the research consisted of 171 students who were studying in the first-grade of Nursing Fundamentals Course in the 2015-2016 academic year. A stratified random sampling method was used in the selection of samples; A total of 66 students were included in the study as 33 for each experimental and control group, and the study was completed with a total of 62 students as 31 for control and experimental groups. In the collection of the data; the experimental group performed the simulation with hybrid simulation (standardized patient + moulage) and the control group performed the simulation with low fidelity simulation (manikin + images of IV fluid treatment complications). After the simulation practice, "Student Satisfaction and Self-Confidence in Learning Scale" and "Simulation Design Scale" were applied. Levels of psychomotor skills and clinical psychomotor skills of the students were evaluated in performance assessment progress. In the analysis of the data, number and percentage distributions, independent groups t-test, Mann-Whitney U test, Wilcoxon test and Chi-Square analysis were used. In order to be able to conduct this research, approval of ethical review board and institution, and the written permissions of students who accepted to participate in the study, the standardized patients and the faculty members were taken. As a result of the research; There was no statistically significant difference between PIC information pre-test mean score of control group (60.96±19.38) and experimental group (60.64±21.89) before the simulation training; after the training, in terms of PIC information post-test mean scores, there was a statistically significant difference found between experimental (82.96±15.53) and control (68.70±20.61) groups (p>0.05; p<0.001). In terms of IV fluid complications information pre-test mean scores, there was no statistically significant difference found between experimental (50.56±23.44) and control (51.20±24.01) groups; after the simulation training, in terms of IV fluid complications information post-test mean scores, there was a statistically significant difference between the experimental (75.00±15.13) and control (58.06±21.05) groups (p>0.05; p<0.001). In experimental group, it was determined that "Student Satisfaction and Self-Confidence in Learning Scale" total mean score (4.67±0.33) were higher than the control group's total mean score (4.24±5.54) and the difference between the scores was found to be statistically significant (p<0.001). In experimental group, it was determined that "Simulation Design Scale" total mean scores (4.63±0.43;4.60±0.39) was higher than control group's mean scores (4.49±0.35;4.54±0.34), however the difference was not found as statistically significant (p>0.05). In terms of mean scores of the PIC skill performance scores of experimental (41.17±3.21) and control group (35.54±4.13); there was a statistically significance found between PIC skill application on real patient scores of experimental (43.91±2.08) and control group (37.90±4.75) (p<0.001; p<0.001). In terms of diagnosis status of IV fluid complications of experimental (71%) and control (45.2%) group students and diagnosis status of IV fluid complications on real patient of experimental (93.5%) and control (29%), there was a statistically significant difference found between the two groups (p<0.05; p<0.05). Students from experimental group stated that working with the standardized patient facilitates communication with the real patient by positively affecting their learning, working with an moulage arm model made the knowlage retention in their memory and therefore they did not face with difficulty in diagnosis the complication on the real patient. As a result of the research, it was determined that the use of hybrid simulation was effective in development the skills of peripheral intravenous catheterization in nursing education and in diagnosis of intravenous fluid therapy complications. Key Words: Nursing education; hybrid simulation; intravenous fluid therapy complications; peripheral intravenous catheterization