Date on Paper

7-2019

Document Type

Doctoral Paper

Degree Name

D.N.P.

Department

Nursing

Committee Chair

Sharon Barton

Committee Member

Vicki Hines-Martin

Author's Keywords

Neonatal Nurse Practitioner competency; simulation training, simulation and competencies; healthcare; procedure; pneumothorax treatment.

Abstract

Pneumothorax in the neonatal period is a potentially life threatening condition that requires Neonatal Advanced Practice Providers to respond rapidly and competently in order to prevent complications of morbidity and mortality. It has become increasingly difficult to establish initial competency as well as maintain competency in low volume high acuity emergency procedures such as chest tube placement. The purpose of this practice based quality improvement project was to implement a simulation based training program in chest tube placement for the Neonatal Advanced Practice Providers within Norton Children’s Neonatology. The goal was to have all Advanced Practice Providers (APP) be able to demonstrate competency in chest tube placement for initial and ongoing clinical practice privileges within the Norton Healthcare System. Participants in the project included five APP within Norton Children’s Neonatology. Data included collecting responses asking the number of chest tubes the APP had placed in the previous two years and collecting APP demographic data through a questionnaire. This was followed by subject participation in a chest tube simulation lab exercise involving chest tube placement for pneumothorax using a high-fidelity mannequin. Post simulation descriptive statistical means and standard deviations were used to assess satisfaction and self-confidence in learning. Mean scores and standard deviations for each participating provider were calculated for each performance point on the Evaluation of the Neonatal Nurse Practitioner Procedural Competency Checklist published by the National Association of Neonatal Nurse Practitioners. It is important for healthcare organizations to employ professionals who can provide timely, effective and safe care. Establishing a continued performance competency stimulation lab in chest tube placement was a evidence based strategy to support Neonatal APP to maintain competency and privileges within the Norton Healthcare system and ultimately improved outcomes for its neonatal population.

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