Miss Hannah Toose1, Ms Rhiannon Beggs1
1Royal Melbourne Hospital, Parkville, Australia
Successful dysphagia management relies on a consistent, coordinated team approach. Patients with dysphagia are vulnerable to choking, pneumonia, malnutrition, increased length of stay and death. E-learning platforms provide quick, effective staff education. Throughout 2013 the Royal Melbourne Hospital recorded high numbers of clinical incidents involving incorrect provision of food, fluids and medications to dysphagic patients. Streamlined nursing education was required, aiming to substantially reduce errors reaching patients.
Key incident themes themes were analysed. In line with adult learning principles, the E-learning tool used problem-based learning with hospital incidents acting as case studies. The tool addresses daily nursing responsibilities, is available via the hospital intranet, accessible to all nursing staff and takes twenty minutes to complete. A pilot of the tool was conducted with eight ‘high risk’ wards. This involved an immediate survey pre and post E-learning training and an additional survey 6-9 months later. Surveys used 10 knowledge based questions and 3 confidence ratings. Low risk ethics approval was obtained.
A higher volume of nurses completed pre training surveys (N=330) compared with immediate post (N=184) and delayed (N=31) surveys, therefore results were compared in percentages. Common scenarios were well imparted, with learnings maintained; complex and infrequent situations demonstrated lesser retention 6-9 months later. Incident trends showed fewer handover issues and more ‘near misses’ not reaching patients.
Significance of the findings to allied health:
The results are pertinent with high demands on limited Allied Health resources. E-learning coupled with adult learning theory can be effective training for nurses in dysphagia. Findings suggest focusing face-to-face education on complex scenarios in order to compliment E-learning training on foundation skills.