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INTRODUCTION: Self-directed learning (SDL) stands as a contemporary approach to learning, offering efficient and sustainable strategies for enhancing knowledge and practices. Given the pivotal role of nurses in ensuring patient safety and care effectiveness, this study aims to assess the impact of the SDL model compared to the traditional learning model (TLM) on elevating nurses' airway management (AM) competencies and minimizing airway-related incidents. METHODOLOGY: The study employed an experimental research design using a posttest-only control group structure within a two-group comparison framework. Seventy-two nurses participated, with 35 in the study group and 37 in the control group at the Obstetrics and Gynecology Hospital affiliated with Cairo University, Egypt. The trial was carried out between February 2020 and July 2021. Following an assessment of SDL readiness for the intervention group, they received SDL model training based on Knowles' SDL principles, while the control group received TLM. The primary endpoint was a significant elevation in nurses' airway management competency, with the secondary outcome being a significant decrease in airway-related incidents reported by nurses. Competency assessments occurred immediately after completion of the intervention and again three months later. RESULTS: A statistically significant difference was observed between the control and intervention groups regarding their practice and knowledge scores, with p-values of 0.02 and < 0.01, respectively. Additionally, the clinically relevant difference between control and intervention groups was evidenced by the effect size (ES) Cohen's d in both practices and knowledge levels (-0.56 and - 1.55, respectively). A significant difference was also noted between the first post-assessment and the paired second post-assessment concerning nurses' knowledge and practices among control and intervention groups, as indicated by the paired t-test with p < .01. Over three months, the intervention group reported 18 airway incidents, while the control group reported 24, with no statistically significant difference (> 0.05). CONCLUSION: The SDL model significantly enhanced nurses' competencies in AM compared to the TLM. However, the efficacy of both learning models diminishes over time. Although nurses who underwent SDL model reported fewer airway incidents compared to those who received TLM approach of learning, no statistically significant difference was detected. TRIAL REGISTRATION: The study has been registered with Clinical Trials.gov under the registration number (NCT04244565) on 28/01/2020.
RESUMEN
BACKGROUND: Evidence-Based Practice (EBP) has been recognised worldwide as a standardised approach for enhancing the quality of healthcare and patient outcomes. Nurses play a significant role in integrating EBP, especially in Intensive Care Unit (ICU). Consequently, this study aims to examine the effect of an adapted evidence-based nursing practices training programme on the competency level of nurses caring for mechanically ventilated patients. METHODS: A prospective open-label parallel 1:1 randomised controlled trial was conducted on 80 nurses caring for ICU patients at the National Hepatology and Tropical Medicine Research Institute, Egypt. The trial was carried out between November 2022 and February 2023 under the registration number NCT05721664. The enrolled nurses were randomly divided into intervention and control groups. The intervention group received the evidence-based nursing practice training programme (EBNPTP) in accordance with the Johns Hopkins EBP conceptional model, whereas the control group received traditional in-service education. Four assessments (one pre- and three post-assessments) were conducted to evaluate nurses' competency level over time using the adapted evidence-based nursing competency assessment checklist. The primary endpoint was an increase the competency levels among nurses caring for mechanically ventilated patients. RESULTS: The current study results revealed statistically significant differences between intervention and control groups in relation to their level of competency across the three post-assessments, with (p <.001). The study also demonstrated that the nurses' competency level continued to decline significantly over time, with (p <.001). Additionally, a significant correlation was found between the nurses' pre-assessment and educational level, acting as independent variables (predictors), and the third endpoint assessment (p <.01), indicated by multiple linear regression. CONCLUSION: The EBP training programme demonstrated a significant increase in the nurses' level of competency compared with traditional in-service education. This suggests that by training the nurses in various settings with the essential skills and knowledge for EBP, their competency level can be enhanced, leading to the delivery of effective care and improving patient outcomes. However, the long-term sustainability of the EBP adoptions was insufficient; further studies are needed to investigate the factors that affect the durability of EBP adoption. TRIAL REGISTRATION: The study was registered with Clinical Trials.gov (Registration # NCT05721664) on 10/02/2023.
