Title : Transformative effects of in situ simulation on nursing skill acquisition
Abstract:
Respiratory distress remains a leading cause of infant morbidity and mortality, particularly during the first 28 days of life, the most vulnerable period for newborns. Timely recognition and effective intervention are essential, yet many practicing nurses lack ongoing, hands-on training to manage these emergencies confidently. While simulation is a proven tool in academic settings, its integration into continuing education for clinical nurses is limited. This quality improvement project evaluated the impact of in situ simulation on nursing knowledge, skill and confidence in identifying and managing respiratory distress in newborns. Practicing nurses from a maternal-newborn care unit, ranging from novice to expert, participated in realistic, high fidelity simulations conducted in their actual clinical environment. Assessments were completed before and after the simulation experience to measure changes in competency. Results showed statistically and clinically significant improvements across skill levels. Participants demonstrated increased accuracy in recognizing respiratory distress and improved execution of resuscitative steps with positive pressure ventilation. Nurses reported enhanced preparedness for real- world emergencies. These gains were seen across all levels of nursing experience. Participants valued the opportunity to practice in a realistic setting, emphasizing that the in situ format strengthened both clinical judgment and team communication. This initiative supports the integration of simulation into routine clinical training offering a practical, effective strategy for improving care delivery. The findings underscore the importance of continuing education that happens in real clinical environments. In situ simulation can play a critical role in elevating nursing competency, promoting patient safety and ultimately improving outcomes for newborns experiencing respiratory distress.
