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Vital for Adult Nurses Update. Phase 1. Provided a diagnostic tool to identify knowledge gaps in the nursing population. Consisted of 14 topic areas with each area assessed by 10 questions. Pass was defined as achieving a mark of 10/10
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Phase 1 • Provided a diagnostic tool to identify knowledge gaps in the nursing population. • Consisted of 14 topic areas with each area assessed by 10 questions. • Pass was defined as achieving a mark of 10/10 • Participants were given one attempt at each assessment component. • Provided a baseline of current levels of nursing knowledge. • Allowed for comparisons across HEFT sites and Bands.
Participation • 84% of the 3173 registered nurses were enlisted onto the e-learning platform (MOODLE). • Approximately 61% of these enrolled population attempted each topic. • Site specific attempt rates revealed that Heartlands Hospital consistently had the lowest attempt rates. • Solihull Hospital had the highest.
Phase 1 Pass Rates Bar chart displaying the overall pass rates across VITAL’s Topics
Phase 1 Pass Rates • Overall: • Evidence that there were gaps in clinical knowledge around key topics. • Possibly because specific knowledge is not frequently required on a daily basis. • Comparisons by banding: • Pass rates generally increased with increasing seniority. • Discharge planning, Falls, Mentorship and Nutritional care were exceptions: Band 8s exhibited less knowledge than their juniors. • Indication that increasing seniority may result in less frequently utilised skills.
Averages • The Kruskal Wallis non-parametric test established whether there were significant differences in averages between groups. • Revealed significant differences in average scores for diabetes, nutritional care and tissue viability between sites (p < 0.05). • Solihull exhibited the lowest averages of the 3 HEFT hospitals. • Comparisons across bands revealed significant differences in all topics apart from Discharge Planning and Safer Medicines Management. • Trend of increasing average scores with increasing seniority. POSSIBLY...... • Supports notion of experiential learning during career progression. • Conversely, highlights challenges of transferring knowledge from specialist nurses to their juniors.
Conclusions & Recommendations • Provides a proof in principle of how VITAL can highlight key knowledge gaps in the nursing population. • Pass mark should be lowered to between 40 and 60% for some modules. • Review the way in which specialist nurses disseminate knowledge and facilitate learning • Especially regarding Tissue Viability and Diabetes care.
Phase 2 • Provided essential learning materials for practicing nurses in order to refine and supplement knowledge. • Assessment consisted of 14 topic, each assessed by 20 questions. • Pass was defined as achieving a mark of 20/20. • Participants were given unlimited attempts to pass each topic. • Inappropriate to compare the scores of individuals who had 1 attempt with individuals who had multiple attempts. • Analysis was only possible on the number of attempts it took to pass each topic (get 20/20).
Participation • 58% of all nurses at HEFT were enrolled onto VITAL. • Significant decline from the 84% observed in VITAL Phase 1. • Increase in attempt rates as over 70% of enrolled nurses attempted each topic. • Similar to Phase 1 Heartlands Hospital still exhibited the lowest attempt rates. • Good Hope Hospital exhibited the highest.
Phase 2 Pass Rates • Overall: • Significantly higher pass rates were observed in comparison to Phase 1: • Phase 1 ranged from 5% to 62% • Phase 2 ranged from 91% to 97% • Clear information bias due to participants being given unlimited attempts. • Unable to identify any knowledge gaps in the nursing population. • NOTE: Pass rates demonstrate a proxy of how many nurses knew 100% of each topic NOT how many nurses knew 60% or 70% or 80% of a topic
Attempts • Attempts taken to complete topics used as an indicator of knowledge. • Similar to Phase 1: Tissue viability, Diabetes and Nutritional care were areas of concern. • No significant differences across sites. • Significant differences across banding for all topics apart from Mentorship. • Evidence that knowledge between bands varies in almost all clinical areas. • Knowledge increases with increasing seniority.
Conclusions and Recommendations • Number of attempts should be limited: • 1 attempt • 2 attempts with an average taken • Human Resources data on clinical specialty should be included for in depth analysis. • Job titles and Clinical area.
Phase 3 • BIGGER and BETTER! • Database will take accurate account of clinical specialties. • Evaluative questionnaire will be appended to capture nurse perceptions of VITAL and e-learning. • For wider discussion..... • Will it be mandatory (for all)? • Will it be used for appraisal? • How will we support staff who fail? • What will the percentage pass mark be set at?
Summary • Phase 1: One attempt • Clear evidence that Diabetes and Tissue Viability are areas of concern. • Phase 2: Multiple attempts • Attempts indicate similar trends to phase 1. • Recommendations • Pass mark should be aligned with tertiary education facilities. • Attempts should be limited • ESR1 data on clinical specialties should be included. • Phase 3: BIGGER & BETTER • Questionnaire will confer robust analysis.
