Improving preeclampsia outcomes: a high-fidelity simulation for undergraduate nursing students

Abstract

Preeclampsia, a hypertensive disorder of pregnancy, commonly affects women and fetuses/neonates, significantly increasing the risk for morbidity and mortality. Underutilization of evidence-based practice standards intensifies complications. Montana has limited resources to care for high-risk pregnancies, especially in rural areas of the state. However, patient outcomes can be improved with standardized care and collaboration. Therefore, it is imperative that all hospitals in the state join forces to improve evidence-based practices for obstetric patients. This quality improvement (QI) teaching project aimed to inform future advocates, nursing students, of the evidence-based guidelines and collaborative tools available in Montana to care for maternal-fetal patients with preeclampsia. The QI project adapted a preeclampsia-focused high-fidelity simulation (HFS) scenario in collaboration with a school of nursing in Montana. The purpose of the HFS scenario was to aid undergraduate nursing students in developing knowledge, psychomotor (technical), and affective (values) skills to manage intrapartum care for a patient with preeclampsia. Senior-level nursing students participated in the simulation process including preparation, pre-briefing, scenario, and debriefing. The students were evaluated on meeting the safe-care measures for an HFS patient with preeclampsia while monitoring for fetal intolerance to labor. Qualitative data were collected based on Kirkpatrick's Four Levels of Training Evaluation tool. The data revealed the students' reactions to the simulation process, plans to apply what was learned, and how the teaching modality helped achieve the learning objectives. The QI teaching project subjectively and objectively improved the students' knowledge, psychomotor skills, and values in caring for a maternal-fetal patient with preeclampsia. Students were also provided with reference materials to use as registered nurses in the event of caring for patients who develop preeclampsia in healthcare facilities throughout Montana.