Healthcare Training
Objectives: Upon completion of this training, the ICU nurses at a hospital in California should be able to:
- state the indications for paralysis.
- describe the procedure for using a Train of Four device to obtain a patient’s baseline and paralysis level.
- properly use the Train of Four device on a patient to assess for appropriate dosing of paralytic medication.
- support the value of properly performing a Train of Four Assessment and documenting baselines.
Background
During the COVID-19 pandemic, nurses more frequently need to properly administer paralytic medicine using a Train of Four, or TO4, Device. However, at a hospital in Fresno, California, Intensive Care Unit (ICU) nurses lacked adequate knowledge on how to use this device to assess paralysis in patients. This is a good skill for nurses to know because if nurses improperly use this device, patients may be given too much paralytic medicine, leading to longer hospital stays and the potential for more complications to occur. At this hospital, the Nurse Educator observed nurses improperly using this device due to a lack of formalized training and assessment. I worked with the Nurse Educator to address this training need and present a new training proposal.
Note: This proposal was created as part of my Master's program and was not actually implemented, but it was reviewed by the Nurse Educator and Instruction Design professionals.
Tools Used: Microsoft Word, PowerPoint
Note: This proposal was created as part of my Master's program and was not actually implemented, but it was reviewed by the Nurse Educator and Instruction Design professionals.
Tools Used: Microsoft Word, PowerPoint
The Challenge
At this hospital, there is no formalized training on using a TO4 device. Nurses typically learn from more experienced nurses. Therefore, some nurses make mistakes or have misunderstandings on how to use the device. Nurses try to make up for this gap in knowledge by defaulting to the maximum voltage when using the device, which they know will be the likeliest to produce twitches in the patients, but this can lead to the nurses believing a patient needs more paralytic medication than necessary.
I do not have experience in the health care field, so I liaised closely with the Nurse Educator to define the training goals, conduct a learner analysis, and present two possible training strategies.
I do not have experience in the health care field, so I liaised closely with the Nurse Educator to define the training goals, conduct a learner analysis, and present two possible training strategies.
Planning for adventure
Because this training was content-heavy, I opted to use the ADDIE model to design the training since it works well when more research is needed in the planning phase and when there is a lot of content to be organized. I began by interviewing the Nurse Educator (my SME) and conducting a learner and resource analysis. I kept in close contact with the SME as I designed the proposal to ensure we were both on the same page and to lessen the need for revisions later.
Snapshots of the Proposal
The final proposal contained:
Please contact me to view the full proposal if desired.
- Learner and resource analysis
- Performance assessment of ICU nurses before the training
- Potential cost for two delivery options: classroom vs. Zoom
- Project timeline and training schedule
- Task Inventory connecting objectives to performance and assessment
- Example training slides
- Evaluation plan with example assessment questions
- A rubric for assessing in-person use of the TO4 device
Please contact me to view the full proposal if desired.
Reaching the destination
What I learned from this project:
- Good communication with your SME is very important. Since healthcare is a completely new field to me, I had multiple meetings with my SME to ensure the training content was accurate and meeting her needs.
- Sometimes more than one training method can work, so proposals can present different options for stakeholders to choose from, including the time and cost for each choice.
- Observable and actionable objectives are important in every training, but even more-so in healthcare - I needed to make sure the nurses actually trained with the equipment they were learning how to use.