How to increase nursing students' competence and safety when handeling patients with dementia in challenging situations

Project summary

The theme in this project is use of simulation in nurse education to train nursing students in handling challenging situation in dementia-care.

In Norway, 66% of all persons with dementia are admitted to a long-term stay in nursing homes. Dementia is usually a chronic or progressive disease with deterioration in cognitive functions such as memory failure, and failure in judgement, planning, thinking or abstraction. Change of personality is also a part of dementia. Behavioural and psychological symptoms in dementia (BPSD) include agitation, anxiety, irritability, depression, apathy and hallucinations, which lead to distress and poor quality of life.

The patient’s capacity to make decisions can be reduced and requires staff with good communication skills and competence regarding ethics and law regulations. The Norwegian law regulates and restricts the use of coercion, but caregivers may experience ethical dilemmas. Reports reveal use of coercion. It is important that health professionals have competence to prevent misinterpretations of the law and coercion without legislative decisions.

Results has showed that use of scenario-based simulation training and ethical reflections regarding reduction of coercion increased by the use of simulation in a psychiatric department caring for adult patients. Our study explores if scenario-based simulation training can increase nursing students’ communication skills in demanding situations in dementia care, improve their ethical reflection and become more aware of situations considered as use of coercion.

The institution recommend use of different learning methods in education. HVL has high-tech and modern simulation areas. Simulation gives students an opportunity to combine theory and practice and to learn from mistakes in a safe environment. The students lean by experiences, and debrief is an important session in simulation. Debrief stimulate the students’ reflection, analyse and synthesis to handle the scenario with more knowledge and skills.

We present the results from focus groups, questionnaire and observation based on participating nursing students in bachelor education. Use of own students in research require ethical reflections.

 

Method

A concurrent mixed-method design was chosen. We used focus groups, questionnaires and observations to explore the participants’ experiences.

The focus groups were based on experiences and observations from the scenarios while the questionnaires focused on simulation as didactic method as well.