El Khamali R, et al. – Authors assessed the impact of an intervention including simulation in reducing work-related stress and work-related outcomes among intensive care unit (ICU) nurses. At 6 months, an intervention that included education, role-play, and debriefing led to a lower prevalence of job strain among ICU nurses compared with nurses who did not undergo this program.

Methods

• Experts conducted this multicenter randomized clinical trial at eight adult ICUs in France from February 8, 2016, through April 29, 2017.
• They included a total of 198 ICU nurses who were followed up for 1 year until April 30, 2018.
• They randomized the ICU nurses who had ≥ 6 months of ICU experience to the intervention group (n=101) or to the control group (n=97).
• Those in the intervention group participated in a 5-day course involving a nursing theory recap and situational role-play using simulated scenarios (based on technical dexterity, clinical approach, decision making, aptitude to teamwork, and task prioritization), followed by debriefing sessions on attitude and discussion of practices.
• The prevalence of job strain assessed by combining a psychological demand score > 21 (score range, 9 [best] to 36 [worst]) with a decision latitude score < 72 (score range, 24 [worst] to 96 [best]) using the Job Content Questionnaire and evaluated at 6 months was included in the primary outcome.
• The seven secondary outcomes were noted including absenteeism and turnover.

Results

• Among 198 randomized ICU nurses (95 aged ≤ 30 years [48%]; 115 women [58%]), 182 (92%) completed the trial for the primary outcome.
• Findings suggested that the trial was stopped for efficacy at the scheduled interim analysis after enrollment of 198 participants.
• The investigators noted lower prevalence of job strain at 6 months in the intervention group vs the control group (13% vs 67%, respectively).
• In the intervention group, absenteeism during the 6-month follow-up period was 1% vs 8% in the control group.
• From the intervention group, four nurses (4%) left the ICU during the 6-month follow-up period vs 12 nurses (12%) from the control group.