Development and Evaluation of a Metric-based Clinical Simulation Procedure for Assessing Ostomy Care in Nursing Practice

Clin Simul Nurs. 2024 Sep:94:101579. doi: 10.1016/j.ecns.2024.101579. Epub 2024 Aug 1.

Abstract

Background: There is a need to understand the clinical decision-making and work practices within ostomy nursing care to support expanding nursing training.

Objective: To develop and evaluate a new metric-based simulation for assessing ostomy nursing care using a human factors approach.

Sample: This pilot study involved eleven stakeholders in the needs assessment, six nurse participants performing simulated ostomy care, and three independent observers assessing procedure reliability.

Method: We conducted a needs assessment of ostomy nursing care and training, developed an enhanced metric-based simulation for ostomy appliance change procedures, and statistically evaluated its reliability for measuring the simulated tasks.

Results: The enhanced metric-based simulation captured different tasks within four task categories: product selection; stoma and peristomal skin care; baseplate sizing and adhesion; and infection control strategies. The video review procedure was reliable for assessing continuous (average ICC≥0.96) and categorical (average κ>0.96) variables.

Conclusion: The new metric-based simulation was suitable for characterizing a broad range of clinical decision-making and work practices in ostomy nursing care.

Keywords: Benner’s model; clinical simulation of ostomy appliance change; human factors in healthcare; ostomy nursing care; simulated ostomy effluent.