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1.
J Cardiovasc Nurs ; 37(3): 289-295, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34091567

RESUMO

BACKGROUND: Ventricular assist device simulation-based mastery learning (SBML) results in better patient and caregiver self-care skills compared with usual training. OBJECTIVE: The aim of this study was to evaluate the effect of SBML on driveline exit site infections. METHODS: We compared the probability of remaining infection free at 3 and 12 months between patients randomized to SBML or usual training. RESULTS: The SBML-training group had no infections at 3 months and 2 infections at 12 months, yielding a Kaplan-Meier estimate of the probability of remaining infection free of 0.857 (95% confidence interval [CI], 0.692-1.00) at 12 months. The usual-training group had 6 infections at 3 months with no additional infections by 12 months. Kaplan-Meier estimates of remaining infection free at 3 and 12 months were 0.878 (95% CI, 0.758-1.00) and 0.748 (95% CI, 0.591-0.946), respectively. Time-to-infection distributions for SBML versus usual training showed a difference in 12-month infection rates of 0.109 (P = .07). CONCLUSIONS: Ventricular assist device self-care SBML resulted in fewer 12-month infections.


Assuntos
Insuficiência Cardíaca , Coração Auxiliar , Infecções Relacionadas à Prótese , Insuficiência Cardíaca/terapia , Humanos , Projetos Piloto , Autocuidado
2.
Clin Simul Nurs ; 53: 1-9, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33747259

RESUMO

BACKGROUND: We developed a simulation-based mastery learning (SBML) curriculum that boosted self-care skills for patients with a ventricular assist device (VAD). In this study, we evaluated short-term skills retention. METHODS: We assessed skill retention among patients and caregivers who participated in VAD self-care SBML at a tertiary care center. We compared discharge skills tests (immediately after completing SBML) to 1- and 3-month follow-up tests to assess skill retention. RESULTS: Fifteen patients and 15 caregivers completed discharge and follow-up testing. Skills were largely retained at 1- and 3-months. CONCLUSIONS: SBML results in short-term retention of VAD self-care skills.

3.
Circ Cardiovasc Qual Outcomes ; 12(10): e005794, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31601111

RESUMO

BACKGROUND: No recognized standards exist for teaching patients and their caregivers ventricular assist device (VAD) self-care skills. We compared the effectiveness of a VAD simulation-based mastery learning (SBML) self-care training curriculum with usual VAD self-care training. METHODS AND RESULTS: VAD patients and their caregivers were randomized to SBML or usual training during their implant hospitalization. The SBML group completed a pretest on 3 VAD self-care skills (controller, power source, and dressing change), then viewed videos and participated in deliberate practice on a simulator. SBML participants took a posttest and were required to meet or exceed a minimum passing standard for each of the skills. The usual training group completed the existing institutional VAD self-care teaching protocol. Before hospital discharge, the SBML and usual training groups took the same 3 VAD self-care skills tests. We compared demographic and clinical information, self-confidence, total participant training time, and skills performance between groups. Forty participants completed the study in each group. There were no differences in demographic and clinical information, self-confidence, or training time between groups. More participants in the SBML group met the minimum passing standard compared with the usual training group for controller (37/40 [93%] versus 25/40 [63%]; P=0.001), power source (36/40 [90%] versus 9/40 [23%]; P<0.001), and dressing change skills (19/20 [95%] versus 0/20; P<0.001). CONCLUSIONS: SBML provided superior VAD self-care skills learning outcomes compared with usual training. This study has important implications for patients due to the morbidity and mortality associated with improper VAD self-care. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT03073005.


Assuntos
Cuidadores/educação , Insuficiência Cardíaca/terapia , Coração Auxiliar , Aprendizagem , Educação de Pacientes como Assunto , Simulação de Paciente , Autocuidado , Função Ventricular Esquerda , Adulto , Idoso , Cuidadores/psicologia , Chicago , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/fisiopatologia , Humanos , Masculino , Manequins , Pessoa de Meia-Idade , Projetos Piloto , Fatores de Tempo , Resultado do Tratamento , Gravação em Vídeo
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