COVID-19 Pandemic: Effects of Replacing Clinical Hours With Virtual Simulation in BSN Prelicensure Nursing Education.

ABSTRACT: At the onset of the COVID-19 pandemic, many academic institutions suspended in-person instruction and clinical experiences. Virtual simulation played an essential role in providing alternatives. The current study used faculty and student surveys, along with standardized exit exams and NCLEX-RN® pass rates, to determine the effect of using virtual simulation instead of traditional hospital clinical experiences during the final semester of a prelicensure BSN program. Results indicated a small decrease in exit exam scores compared to those who completed the traditional clinical experience and no significant relationship between NCLEX-RN pass/fail rates.

Impact of a modified early warning score on nurses' recognition and response to clinical deterioration.

AIMS: (a) Improve nurse knowledge of and confidence in responding to clinical deterioration through implementation of the Modified Early Warning Score tool and (b) improve nurse ability to react to patient deterioration in a timely manner. BACKGROUND: Recognition of clinical deterioration in hospitalized inpatients often occurs far after those signs initially present. The Modified Early Warning Score has been shown to assist with recognition earlier in the deterioration process. METHODS: Eighty-five nurses participated in a simulation-based intervention to implement the Modified Early Warning Score into their rural hospital. Group classroom sessions and individual high-fidelity simulation experiences were provided for participants. Twenty-nine nurses also participated in self-confidence and knowledge assessment testing. RESULTS: The simulation-based intervention significantly improved nurse knowledge (t = 4.029, p < .01) and self-confidence (t = 3.698, p = <.01). Chart reviews found a 34.1% increase in nurse action taken in response to signs of clinical deterioration. CONCLUSION: Current study found that the Modified Early Warning Score tool as taught through a simulated patient experience is useful to prevent unrecognized deterioration. IMPLICATIONS FOR NURSING MANAGEMENT: Suggests that a simulation-based intervention is effective for teaching and evaluating post-licensure nurses on acute clinical deterioration in inpatients.