Alkoholista päihtyneiden potilaiden hoitaminen päivystyspoliklinikalla: Hoitohenkilökunnan osaaminen ja verkkokoulutusintervention vaikutus osaamiselle

Kaisu-Leena Mäkelä

Research output: Book/ReportDoctoral thesisCollection of Articles

Abstract

The emergency department is often the first healthcare unit where people end up due to symptoms or accidents caused by alcohol. Therefore, it is important that the emergency department staff knows how to treat such patients in the right way, by asking about the amount of alcohol use, by discussing it and, if necessary, by referring the patient to a suitable further treatment facility.

The purpose of this dissertation research was to describe the acutely ill alcohol-intoxicated patient caring skills of the nursing staff working in the emergency department and their skill development through an educational intervention. The goal was to enable the development of the skills of emergency care staff with the help of the web-based education program produced and thus promote the quality of care of an alcohol-intoxicated emergency department patients. The study was part of a project that has investigated the quality of the treatment of alcohol-intoxicated patients as well as the attitudes and skills of the nursing staff in the emergency room.

The dissertation consists of three sub-studies. In the first part of the study, the nursing staff's skills to care for alcohol-intoxicated emergency patients in Finnish emergency departments (N = 1220, n = 252) was investigated. These skills were at a moderate or good level and the highest ratings were given to safety and ethical skills. The nursing staff of the emergency department assesses the skills to assess follow-up care and the risk of alcohol use to be their weakest area of competence. Receiving further education during the working career had the most positive effect on the competence examined in this study.

In the second phase, a competence scale was validated, which was used to measure the skills in the first phase. The Nurses’ Skills to Care for Alcohol-Intoxicated Patients in Emergency Department (NSCAIP-ED) instrument was developed using a multi-methodology approach, and in addition to researchers, it also involved experts in substance use and emergency nursing. The instrument was evaluated on the basis of its content and usability, as well as with the help of statistical analyses. Confirmatory factor analysis was used as statistical analysis and Cronbach's alpha values were calculated. Based on the validation, the instrument seemed reliable. Based on the results, it is also possible to use it in follow-up studies in a similar research environment when examining the self-evaluated skills of the nursing staff in caring for alcohol-intoxicated patients.

In the last phase, a web-based education program for nurses’ self-assessed skills concerning the care of alcohol-intoxicated patients in the emergency department was evaluated before and after the intervention. In cooperation with Diakonia University of Applied Sciences, a web-based education program was developed for the nursing staff of the emergency department. Education including evidence-based information regarding the care of a patient intoxicated by alcohol in the emergency department. The intervention group (N = 20) and the control group (N = 25) were randomly selected from the nurses of one emergency department (N = 90). Both groups completed the self-assessment of skills with the NSCAIP-ED instrument in the initial phase of the study when the intervention group had not yet received the web-based training intervention. A new measurement with the same instrument was performed for both groups after completing the web-based training. The members of the intervention group assessed that their skills had improved after the web-based education program, statistically significantly in several different areas of the competence scale used in the measurement. The web-based training turned out to be well suited as a continuing education method implemented in the emergency department. Based on the results, it had a positive effect on the intervention group's self-assessed skills in caring for alcohol-intoxicated emergency department patients.

Based on the results of the sub studies, a model was created to support the nursing staff's skills in caring for alcohol-intoxicated patients in the emergency department. The model includes the content of competences that are needed in the treatment of the patients described above, an instrument that can be used to measure the skills in question, and a proposal for an intervention that can be used to improve these skills. No previous research information on a similar model could be found, so this research produced new evidence-based information. In the future, the model and its content can be used in practical nursing work as needed. In terms of the best possible treatment of the patient, it is important that such information is used in the emergency department both nationally and internationally.
Original languageFinnish
Place of PublicationTampere
PublisherTampere University
ISBN (Electronic)978-952-03-3425-3
ISBN (Print)978-952-03-3424-6
Publication statusPublished - 2024
Publication typeG5 Doctoral dissertation (articles)

Publication series

NameTampere University Dissertations - Tampereen yliopiston väitöskirjat
Volume1015
ISSN (Print)2489-9860
ISSN (Electronic)2490-0028

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