Effectiveness of Online Patient Safety Education on the Competency of Nurses in Intensive Care Units: A Quasi-experimental Study

Maintaining patient safety (PS) is one of professional and ethical duties of health care providers. Nurses, as the largest professional group in the health system, have a potential and significant power in influencing the health care quality. Their competency in PS is essential to ensure quality and safe care. Education plays a vital role in improving PS and providing high quality nursing care. Due to the prevalence of COVID-19 and the need to observe social distancing, it is not possible to hold face-to-face courses. Hence, e-learning is a valuable option during this pandemic. This study aims to evaluate the effectiveness of online PS education on the competence of nurses in intensive care units (ICUs).

This is a single-group quasi-experimental study with a pre-test/post-test design that was conducted in 2020 in Tehran, Iran. Participants were 50 nurses working in the ICUs of Hazrate Rasoole Akram Hospital and Firoozgar Hospital affiliated to Iran University of Medical Sciences, who were by a proportional stratified sampling method. The content of the educational program was prepared using clinical guidelines and the literature which included materials about (1) PS and its different aspects (medication error, hemovigilance, pressure ulcer, fall, nosocomial infections, hand hygiene, surface and equipment disinfection, and waste management), (2) PS culture, (3) the effects of human factors and teamwork on error incidence, (4) importance of communication with patients before and after the occurrence of errors and giving appropriate feedback on errors, (5) root cause analysis of errors, (6) activity analysis after an adverse event, and (7) risk management. The program was prepared using Storyline version 3 software. Educational content was provided to participants on Telegram application. Before and three months after the intervention, data were collected using the Patient Safety Competency Self-evaluation (PSCSE) questionnaire. Data were analyzed by descriptive statistics (frequency, mean, and standard deviation) and inferential statistics (paired t-test) in SPSS software, version 22.

The mean scores of PS knowledge (21.75±3.28), attitude (61.52±4.19) and skill (84.66±53.7) after the intervention were significantly higher compared to their pretest scores (P<0.001). The mean of total competency score (167.93±11.61) was also significantly higher after the intervention. Results showed that the educational program improved the nurses' competence by 17.86%. The education had the highest effect on PS knowledge, followed by PS skills and attitudes.

Online education can increase PS knowledge, skills, and attitudes in ICU nurses and can ultimately promote their competence in PS. Nursing managers can use e-learning method to provide in-service training and retraining courses on familiarity with PS concepts, which can help manage medical errors caused by nurses. This learning method is recommended for nurses working in ICUs, especially during the COVID-19 pandemic.