The Importance of Simulation-Based Continuous Renal Replacement Therapy Training in Nurse Education

Introduction: Over the last years, many technical advances have been made in the delivery of continuous renal replacement therapy (CRRT). However, little attention has been given on the optimal care delivery model for CRRT. Optimal care delivery model for CRRT relies on expert bedside nursing staff to maintain prescribed therapy, troubleshoot technical issue and ensure patient safety. CRRT in the intensive care unit (ICU) requires a theoretical and practical training through educational process able to replicate clinical practices in a safe environment. Simulation-based learning in nurse education could be an effective teaching and learning method: in particularly, critical care nurses are a potential receptive professional group for CRRT training. The purpose of this review is to analyze the quantitative evidence of educational strategy in nursing training for CRRT. Methods: A review of quantitative studies published between 1996 and January 2014 was undertaken using the following databases: CINAHL Plus, ERIC, Embase, Medline, SCOPUS, ProQuest, ProQuest Dissertation and Theses Database. The primary search terms were ‘human simulation CRRT’ and ‘nursing training CRRT’. All articles identified were English-language, full-text papers. We also searched the reference lists of identified articles for further relevant papers and the websites of relevant nursing organizations. Results: Six studies were included in the review. Two of the studies indicate that education, continuing competence, prevention and management of adverse events, such as bleeding and filter clotting, are the major issues related to CRRT nursing. One of these two studies showed the importance to establish training programs and to define the role of teaching nurse. One quasi-experimental study showed the introduction in nursing education of self-learning manuals as useful aids and catalysts to achieve more effective and satisfying learning experiences. Two observational studies evaluated the impact of a program designed to improve CRRT stability on unexpected circuit clotting and the effectiveness of CRRT delivery with an ICU bedside nurse delivery model for CRRT, while comparing circuit patency and circuit exchange rates. One prospective quality controlled observational study evaluated the importance of simulation–based educational model in nursing training for CRRT with a significant and sustained improvement in the delivery of CRRT demonstrating by marked increase in filter lifespan. Conclusion: Simulation-based learning in nursing education could be a valid teaching and learning strategy. Highest level nurse to the bedside represented by a nephrology–critical care nurse can help to fil the gaps in delivering CRRT practice. Additional studies are needed to support simulation-based learning in nursing education.