Pediatric Hematology Oncology Nurse St Jude Children's Research Hospital memphis, Tennessee, United States
Title: Implementing a Fever Workup Skills Day for Nurse Residents to Improve Care and Confidence
Abstract : Basis of Inquiry
Fever in the pediatric oncology patient population is considered a medical emergency and providing quality care in this setting is imperative. The Nurse Residency Program (NRP) board members at our institution noted that nurse residents entering the clinical environment were not adequately prepared to manage a fever workup for oncological patients. In response, a skills day was implemented.
Purpose/Objectives
The purpose of this education program was to provide didactic and hands-on experience for nurse residents to increase knowledge, skills, and confidence in managing a fever.
Methods
Skills day took place on campus during one of the NRP didactic education sessions. A progressive scenario of a febrile oncology patient was developed. Didactic content on the interventions necessary for the patient as the scenario progressed was discussed. Corresponding hands-on skill practice for each didactic component was simulated. At the beginning of the scenario, didactic content discussing vital signs, fever, and the expected interventions of blood cultures, antibiotics, and acetaminophen were presented alongside a fill-in-the-blank worksheet. The residents then practiced drawing blood cultures on a mannequin. As the scenario progressed, the patient became hypotensive, and the provider ordered a bolus. After discussing this intervention, residents were able to practice bolus administration via rapid infuser. A pre- and post-test was conducted including questions rating confidence in managing interventions relevant to a fever workup and knowledge-based questions. A 1-year post survey will be conducted to assess the long-term effects of this education program.
Findings/Outcomes
From March 2024-February 2025, 40 out of the 41 residents completed the fever workup skills day. One hundred percent of residents had an increase in confidence from pre- to post-test scores. There was also a notable increase in correctly answering knowledge-based questions in the post-test.
