Effect of Implementing Simulation Education on Health Care Worker Comfort With Nasopharyngeal Swabbing for COVID-19. (August 2020)

• Record Type: Journal Article
• Authors: Mark, Michelle E.; LoSavio, Phillip; Husain, Inna; Papagiannopoulos, Peter; Batra, Pete S.; Tajudeen, Bobby A.
• Is Part Of: Otolaryngology--head and neck surgery. Volume 163:Number 2(2020)
• Page Start: 271
• Page End: 274
• Publication Date: 2020-08
• Subjects: COVID-19 -- coronavirus -- nasopharyngeal -- testing -- swab -- education -- otolaryngology -- simulation -- PS/QI; Head -- Surgery -- Periodicals; Neck -- Surgery -- Periodicals; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/0194599820933168
• Languages: English
• ISSNs: 0194-5998

Abstract

Objective: To determine if rapid implementation of simulation training for the nasopharyngeal swab procedure can increase provider confidence regarding procedure competency. Methods: A simulation training exercise was designed as a departmental initiative to improve competency performing nasopharyngeal swabs during the COVID-19 pandemic. Sixty-one health care workers attended teaching sessions led by the Department of Otorhinolaryngology on proper nasopharyngeal swab technique. After a brief lecture, participants practiced their swab technique using a high-fidelity airway simulation model. Pre- and postintervention self-evaluations were measured via standardized clinical competency questionnaires on a 5-point Likert scale ranging from "No knowledge, unable to perform" up to "Highly knowledgeable and confident, independent." Results: Forty-six participants in this study submitted pre- and postintervention self-assessments. Postintervention scores improved on average 1.41 points (95% CI, 1.10-1.73) out of 5 from a mean score of 3.13 to 4.54 ( P < .0001). This reflects a large effect size with a Glass's delta value of 1.3. Discussion: Lecture coupled with simulation-based teaching can significantly improve health care workers' confidence in performing nasopharyngeal swabs. Proper training for frontline workers performing swabs for COVID-19 is essential to improving testing accuracy and can be achieved in a simple and timely manner. Implications for Practice: To meet the testing needs of the growing pandemic, many health care workers who are unfamiliar with nasopharyngeal swabs have been asked to perform this test. Simulation-based teaching sessions may improve health care workers' confidence and help prevent false-negative results. This intervention is easily reproducible in any setting where frequent nasopharyngeal swab testing occurs. Level of Evidence/Study Design: Prospective cohort study.