Blue Ribbon Abstract Award: Changing Healthcare Worker Behavior in Relation to Respiratory Disease Transmission with a Novel Training Approach That Uses Biosimulation

BACKGROUND/OBJECTIVES: Respiratory disease transmission continues to be an area of safety concern for healthcare personnel (HCP). We describe an experiment that uses a novel training method to demonstrate dispersion of particles during respiration and cough within the context of respiratory disease transmission. The study was conducted to determine whether supplementing standard classroom training methods regarding disease transmission with a visual demonstration can improve the use of PPE among Emergency Department (ED) nurses. METHODS: Participants in a pilot study included 20 ED registered nurses. General demographic information was obtained. All subjects first participated in classroom training dealing with infection control and disease transmission then completed a pre- and post-test to determine knowledge level. Subjects were then randomized into two groups, control and intervention. The intervention group received supplemental training consisting of a visual demonstration of respiratory particle dispersion using a human biosimulator. Both groups were then observed throughout their work shifts as they provided care during January-March 2005. RESULTS: Both the intervention group and the control group completed standard classroom training. The pre classroom training knowledge assessment indicated no difference between the intervention and control groups (t(19) = 1.11, p = .28). In the final dataset, there were 84 observations evaluated with 42 in each group. A Fisherʹs Exact test was performed to determine if the visual demonstration increased appropriate PPE use relative to the standard training alone. Results indicate that the standard training plus biosimulation significantly increased the use of PPE by nurses when providing care for patients with respiratory symptoms (p = .04). CONCLUSIONS: Analysis comparing the use of PPE between the subjects trained with or without a visual demonstration indicated that those who received the visual demonstration used PPE more often. The additional training resulted in a 21% increase in the use of PPE (74% versus 53%). This indicates that supplementing the standard training methods with a visual demonstration can improve the use of PPE by nurses when providing care for patients exhibiting respiratory symptoms. Supported by the Research Foundation for Prevention of Complications Associated with Health Care and cooperative agreements with the Health Resources and Services Administration and the Centers for Disease Control and Prevention.