Defining expertise in paediatric orthopaedic nursing

Does a specialised orthopaedic trauma module utilising high fidelity simulation improve student nurses' perceptions of their competence? A pilot study

BACKGROUND

Trauma is the fourth leading cause of death in the western world, and traumatic injuries are recognised as clinically challenging to care for. Orthopaedic trauma care is not standard content in pre-qualifying nursing curriculums, compounded by a dearth in specialised post-qualifying education internationally. As a result, registered nurses may not have the clinical skill set to appropriately manage patients with traumatic conditions.

AIMS

To understand pre-qualifying student nurses' perceptions of their own competence in orthopaedic trauma care and understand if utilisation high fidelity simulation improves confidence, knowledge and application of theory.

METHODOLOGY

A small-scale qualitative pilot study utilising purposive sampling, designed to inform the development of a larger longitudinal study. A 5-point likert scale questionnaire with options for qualitative comments was administered after 8 weeks of a specialised module culminating in a high-fidelity simulation and in-depth debrief session. Thematic analysis was conducted.

FINDINGS

All students found that the module improved their confidence and knowledge in their skills set. The high-fidelity simulation was found to be an effective learning environment to translate theory to practice.

CONCLUSIONS

Specialised orthopaedic trauma training is effective in improving student nurses' knowledge and perceived competence in trauma care. High fidelity simulation is a valuable teaching tool to develop student's skill sets in complex scenarios and support application of theory to practice.

Updating the UK competence framework for orthopaedic and trauma nurses 2019

The updated RCN Competence Framework for orthopaedic and trauma practitioners was published in 2019 following completion of a 2 year project undertaken by a working group of representatives from England, Northern Ireland, Scotland and Wales. Expert musculoskeletal practitioners, including an allied health professional and working across the lifespan in varying domains of orthopaedic and trauma practice, collaborated to produce a working document applicable to trauma and orthopaedic (T&O) practitioners from all NHS (UK) pay bands. The 2019 document builds on the original and subsequent versions (2005 and 2012), importing new evidence and reformatting it so that it is contemporary and easily cross referenced with the NMC Code (2018). The restructure includes an example of a learning contract demonstrating how the framework can be applied in practice, whether for self-learning, or in conjunction with the revalidation process. This paper reflects on and describes the process undertaken by the working group in the development and restructuring of the 2019 framework, including its evaluation to date and planned in the future.

Should the development of orthopaedic trauma nursing be a priority in low to middle income countries? A scoping review

BACKGROUND

Traumatic orthopaedic injuries are responsible for 5.8 million deaths every year, with 90% occurring in low to middle income countries. Nursing is an under-utilised resource in global trauma care and little research exists into the availability or training of skilled orthopaedic nurses in low to middle income countries.

OBJECTIVES

This scoping review aimed to summarise and critique the existing body of research to identify if the development and, in some cases establishment, of trauma and orthopaedic nursing should be a priority in low resource settings. The review also aimed to identify any barriers to the advancement of the speciality, and any existing solutions to support nurses' training and development.

METHODOLOGY

A scoping literature search was conducted, searching four databases (ProQuest, Medline, CINHAL and SOLAR) with key words and phrases to identify current literature.

RESULTS

Eleven papers were identified. Key themes included the need to upskill and utilise the existing nursing workforce to provide care to trauma patients.

CONCLUSIONS

Significant investment in the development of orthopaedic nursing is needed in low to middle income countries to reduce morbidity and mortality and retain the local nursing workforce.

International scoping exercise into expertise in children's orthopaedic nursing and educational pathways

Maintaining competence and keeping skills and knowledge in children's orthopaedic nursing alive are problematic in both the UK and Australia. The dearth of dedicated postgraduate courses for this specialty has resulted in an array of unregulated in-house training, nurses' individual educational needs not being met and potential for children with an orthopaedic problem being put at risk of not receiving optimal care. This paper reports on a travel scholarship used to compare and contrast the UK with Australia, which supported an international scoping exercise to identify nurses' beliefs regarding expertise in children's orthopaedic nursing and explore provision for maintaining pertinent knowledge and skills. Potential ways to improve support for nurses in maintaining expertise in this field of practice are discussed.