Purpose: The purpose of our initiative was to enhance annual competencies of clinical staff in the medical-surgical areas through innovative evidence-based strategies.
Description: Staff competency is essential to provide adequate care to patients. Validating staff’s ability to perform skills within their role has traditionally been designed based on staff’s lack of proficiency in performing a designated skill. Although these skills are evaluated on a set frequency basis, completing this process has brought dissatisfaction. clinical nurse educators (CNEs) identified a need for engaging nurses through an active learning environment and pursued a change with annual competencies for clinical staff. A learning needs assessment was conducted in four medical-surgical units and as a result, unit-based competencies were identified.
The concept of an escape room activity was adapted and tailored to meet the needs of competency validation. Competency skill stations were designed separately for both registered nurses (RNs) and clinical partners (CPs). Groups of 6 to 8 staff completed the activity within a 1.5-hour time frame. A pre-test and post-test were conducted to measure knowledge before and after completion of the activity, and an evaluation form was completed by all staff.
Evaluation/outcomes: A total number of 120 RNs and 45 CPs were able to complete the activity in a total of 29 and 10 sessions respectively. The sessions took place over a period of 4 months. RNs completed twelve and CPs completed five competencies. There was a significant improvement from pre- to post-test. The pre-test average scores measuring knowledge for the RNs were only 50%, and post-test increased to 91%. Additionally, the CPs pretest average scores were 42%, and post-test increased to 92%. Staff evaluations determined a 100% satisfaction rate with the activity in which the main statements denoted innovation as the reason for such contentment. Furthermore, nursing code documentation has improved significantly.
Implications for practice: Nurse educators need to find new evidence-based strategies to engage active learning while increasing level of competency. The escape room proved to be one strategy that had positive results by increasing competency and satisfaction and thus can positively reflect an improvement of clinical outcomes.