Validation of an Immersive Virtual Reality Based Experiential Learning Simulator to Improve Medication Administration Safety Skills of Registered Nurses

项目摘要 在美国，大约2%的住院患者经历过有害影响 从与给药有关的错误中解脱。这些错误也起到了一定作用 将住院患者的住院时间延长至最多10天。38%的错误与 用药是在给药过程中进行的。给药错误被定义为 与记录在病人记录上的处方者用药顺序不一致，制造商的 准备、行政指示或体制政策/程序“。《关节》 委员会的2017年国家患者安全目标肯定了药物治疗的持续重要性 通过建立以改善使用为重点的目标来管理患者的安全 医院内的药物。联合委员会的建议包括贴标签 所有药物和药物容器；所有药物和解决方案的验证 由两名合格的个人进行口头和视觉检查；并通过输入 以及在换班期间离开员工。作为医疗保健专业人员，注册护士拥有 有责任在以下范围内安全地对患者进行不同类别的药物管理 社区医院设置。联合委员会的建议只有在以下情况下才有效 直接参与给药过程的注册护士可以在 遵守提议的协议。此外，意外中断和其他人为因素 与压力、睡眠不足和教育程度有关的因素可能会干扰药物的使用。 管理流程，并促成不良患者安全事件。另外， 条形码和计算机管理程序等技术进步使它 护理专业人员需要了解最新的知识和预期的实践 与用药有关的行为。此外，培训时间、成本、 缺乏最佳的教育平台影响了医院机构提供 对实习护士进行持续用药安全能力培训。按顺序 为了解决上述问题并在模拟环境中提供培训，我们建议 开发沉浸式虚拟现实体验式仿真环境进行护理培训 安全用药管理方面的专业人士。我们提出两个具体目标，以实现和 证明我们模拟器的有效性。在目标1中，我们将开发具有以下功能的模拟器 模拟用药的方方面面。在目标2中，我们将进行验证研究 以证明模拟器的面貌、内容和预测有效性。

Project Summary In the United States, approximately 2 % of all hospital inpatients have experienced harmful effects from errors associated with the administration of medications. Such errors have also contributed to increased length of stay of up to 10 days for hospitalized patients. 38% of errors related to medication happens during administration. A medication administration error is defined as a “deviation from the prescriber’s medication order as written on a patient’s record, manufacturer’s preparation, administration instructions, or institutional policies/ procedures”. The Joint Commission’s 2017 National Patient Safety Goals affirm the continued importance of medication administration to patient safety by establishing a goal focused on improving the use of medications within hospitals. The recommendations from The Joint Commission include labeling all medications and medication containers; verification of all medication and solutions both verbally and visually by two qualified individuals; and proper review of medications by entering and exiting staff during shift changes. As healthcare professionals, Registered Nurses have the responsibility to safely administer diverse classifications of medications to patients within community hospital settings. The Joint Commission recommendations can only be effective when Registered Nurses directly involved in the medication administration process can be trained in adhering to proposed protocols. Moreover, unexpected interruptions and other human factors related to stress, lack of sleep, and education level have potential to interfere with the medication administration process and contribute to an adverse patient safety event. Additionally, technological advances such as bar code and computer administration programs make it necessary for nursing professionals to keep up-to-date on knowledge and expected practice behaviors associated with medication administration. Moreover, scheduling of training time, cost, and a lack of optimal educational platforms impact the capacity of hospital institutions to offer continued medication administration safety competency training to the practicing nurse. In order to address the above issues and provide training in a simulation environment, we propose to develop a an immersive virtual reality experiential simulation environment to train nursing professionals in safe medication administration. We propose two specific aims to achieve and prove the effectiveness of our simulator. In aim 1 we will develop the simulator with capabilities to simulate all aspects of medication administration. In aim 2, we will conduct validation studies to prove face, content and predictive validity of the simulator.