SC29 Simulation in nursing communication (SINC)

Background A Trust survey in 2017 showed a concerning decline of patient confidence and trust in nursing staff, and this coincided with a drop in nursing recruitment and retention. To investigate, a telephone survey gained a more detailed account of what negatively impacted patient experience, and what could help improve the nursing relationship. Patients regard nurses as emotional support during an unstable period of their lives. They reported feeling more assured about their illness when they were able to interact positively with their nurse, and had a better experience of the healthcare system overall. Therefore, the simulation department was tasked by Trust executives to design a course to improve nurse communication skills. A scoping exercise revealed the main challenges faced were; dealing with angry patients and relatives, duty of candour, challenging hierarchy, safeguarding, delirium and end of life care. Programme A course consisting of forum theatre and five challenging communication scenarios using simulated patients was designed. The course starts with forum theatre to create a non-judgemental learning environment and encourage group interaction. This is followed by immersive scenarios exploring themes from the survey and scoping exercise. Results Since March 2018, over 100 nurses have been trained. Every participant strongly agreed that the course helped boost their confidence in communicating and they also strongly agreed that simulation is a good environment for this type of learning. Discussion There is recent evidence of increased recruitment and retention within nursing at the Trust and this course could be one of the positive driving elements. Qualitative research is being undertaken on the lasting changes to practice, care and interactions following attendance. Findings will be reported in summer 2019. Additionally, during delivery of this course, deep rooted cultural issues were identified around end of life care and challenging hierarchy. Consequently, further work has been undertaken in the Trust to address it. Conclusion Seeing the benefits of this course, the nursing strategy group has made it mandatory for all nurses and provided funding. Peer reviews have been conducted with excellent feedback and other professional groups are in the process of designing similar courses. We found that uni-professional learning of this kind encourages participation and may provide grounding for more valuable participation in a multidisciplinary course as a second stage to further their development. To close the loop, we will review patient survey data in the coming year to assess impact on the patient-nurse relationship.