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Theses Doctoral

The Development, Implementation, and Summative Evaluation of a Therapeutic Hypothermia Online Self-learning Module, Protocol and Checklist for Registered Nurses: Implications for Training and Practice

Donnelly, Claire

Nurses, especially those who care for the critically ill, are required to perform high-level intensive clinical care. It is common for complicated procedures such as therapeutic hypothermia (TH) to be done infrequently at small community hospitals. According to the 2020 recommendations by the American Heart Association (AHA), “prompt initiation of targeted temperature management (formally known as TH) is necessary for all patients who do not follow commands after return of spontaneous circulation to ensure optimal functional and neurological outcome” (Panchal et al., 2020, p.S366).

These high-risk, low-frequency protocols typically require nurses to be able to perform these procedures in a time-sensitive manner. If the procedures are not done correctly, they can have negative patient outcomes. Patients are put into medically induced comas, maintained on ventilators, cooled to very low body temperatures, and often medically paralyzed to inhibit shivering. Each of these conditions has the potential for adverse outcomes and together can lead to poor neurological outcomes and even death (Kim et al., 2015). Health educators have the opportunity to provide knowledge and support to these nurses as a way to improve patient outcomes.

In this study, a patient care checklist and an online self-learning module were developed for nurses to learn how to perform this high-risk procedure quickly and effectively. A focus group was then conducted with a group of nurses to gain feedback on the checklist and module, and these data informed specific changes to these materials. Then, drawing on a sample of 60 nurses and using a post-study design, data were collected to determine the effectiveness of the checklist and online module as compared to a control group of nurses who read a scholarly article on the same subject. Data were collected at two time points for both the experimental and control groups.

The results indicated that nurses who used the online learning tool scored higher in the post-assessment than those in the control group (t = 6.092, p < .001, BCondition = 3.865), with a remarkably high effect size, r2 = 0.379. Moreover, 77% of the nurses agreed that protocols and checklists helped nurses minimize disparities in patient health outcomes. Additionally, 95% of the nurses agreed that patient care checklists helped them care for patients when delivering high-risk, low-volume protocols such as TH. This study demonstrated that online learning tools provide an effective way to educate nurses, and checklists and protocols support the implementation of high-risk, low-volume procedures such as TH.

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More About This Work

Academic Units
Health and Behavior Studies
Thesis Advisors
Rajan, Sonali
O'Connell, Kathleen
Degree
Ed.D., Teachers College, Columbia University
Published Here
November 3, 2021