Date of Publication


Project Team

Rebecca A. Bent, Marcia Bosek, Jean Coffey



Purpose: Simulation based education for inpatient nurses is considered an effective teaching strategy and has been shown to increase nurse satisfaction, skills acquisition and positive patient outcomes. Nurses are highly satisfied with skills acquisition when performed in a simulation center and demonstrate improved skills performance. Simulation environments provide an ideal place for skills competency sign off as it is a place where mistakes can be made and learned from with no risk of harm to patients. A New England based 350 bed academic medical center (AMC) has consistently scored poorly on National Database of Nursing Quality Indicators surveys for nursing satisfaction and nursing education. Historically 10% of nurses on an26 bed med/surge unit do not pass all their competencies the first attempt. As a result, the AMC nursing leadership decided to update the skills competencies process. The AMC provided space in the SIM center for a 24-hour skills day to be tested, with a goal of unit wide skills sign off, increased nurse satisfaction, increased pass rate on three skills. The skills being signed off are catheter insertion, central line dressing change and blood administration.

Methods: This project targeted the registered nurses employed on one med/surg unit at the AMC. The intervention was a 24-hour skills competency sign off at the SIM center. To prepare for the education session, the nurses were emailed PDF’s of the policies, procedures, job aids and video illustrating correct skills technique to prepare for skills/competency sign off. Nursing satisfaction was measured by a pre-post intervention written survey. Chart audits were performed for a month pre and post intervention to collect data on the number of CAUTI/CLABSI and blood administration documentation accuracy.

Results: 25 nurses (100%) of the nursing staff from the medical surgical unit participated in the pre-intervention staff satisfaction survey. 20 nurses (100%) of the nursing staff that participated in the skills day participated in post-intervention staff satisfaction survey. Every question on the staff satisfaction survey was significantly higher (more positive) at post than at pre (p < 0.001). 100% of the staff that attended the 24-Hour skills day passed all three skills competencies on the first try. The incident of CAUTI/CLABSI remained unchanged. The proportion of correct blood administration in “pre” (0.35) is not significantly different from the “post” proportion (0.44), using a test comparing two independent proportions (p=0.65).

Conclusion: A 24-hour skills day is an effective method for improving nursing satisfaction and skills competency completion. CLABSI/CAUTI incidence were unchanged. Accuracy of blood administration documentation was not statistically different pre and post intervention.

Keywords: Nurse Satisfaction, nursing skills, nursing competency, simulation-based training, CAUTI, CLABSI, blood administration

Document Type


Included in

Nursing Commons