« Une stratégie de formation multimodale, incluant simulation et débriefing, peut-elle avoir une influence sur le stress des infirmiers de médecine intensive réanimation ? »
L’équipe paramédicale de l’hôpital Nord de Marseille, a mené un travail (financé en tant que PHRI-P) sur cette question, et les résultats très positifs sont publiés dans le JAMA le mois dernier (24 octobre).
Au nom de la SRLF et de la CCI je voulais souligner la parution de cet article infirmier dans une revue de référence. Félicitations aux soignants de Marseille pour la grande qualité et le sérieux de leur travail qui ont permis la parution de cet article.
De plus, ce papier a été présenté par une des auteurs, Sabine Valera, membre infirmier du CA de la SRLF, lors des « hot topics sessions » du congrès européen de médecine intensive ESICM 2018.
Voilà un exemple à suivre pour les équipes infirmières francophones !
Secrétaire de la Commission du Congrès Infirmier de la SRLF
Question Can a multimodal program that includes education, role-play, and debriefing reduce job stress among intensive care unit (ICU) nurses?
Findings In this randomized clinical trial including 198 ICU nurses in France, the prevalence of job strain (assessed by a questionnaire that included psychological demand and decision latitude evaluation) was significantly reduced at 6 months among nurses in the 5-day intervention group (13%) compared with those in the control group (67%).
Meaning A multimodal program may be effective in reducing job stress among ICU nurses.
Importance Nurses working in an intensive care unit (ICU) are exposed to occupational stressors that can increase the risk of stress reactions, long-term absenteeism, and turnover.
Objective To evaluate the effects of a program including simulation in reducing work-related stress and work-related outcomes among ICU nurses.
Design, Setting, and Participants Multicenter randomized clinical trial performed at 8 adult ICUs in France from February 8, 2016, through April 29, 2017. A total of 198 ICU nurses were included and followed up for 1 year until April 30, 2018.
Interventions The ICU nurses who had at least 6 months of ICU experience were randomized to the intervention group (n = 101) or to the control group (n = 97). The nurses randomized to the intervention group received 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), which were followed by debriefing sessions on attitude and discussion of practices.
Main Outcomes and Measures The primary outcome was the prevalence of job strain assessed by combining a psychological demand score greater than 21 (score range, 9 [best] to 36 [worst]) with a decision latitude score less than 72 (score range, 24 [worst] to 96 [best]) using the Job Content Questionnaire and evaluated at 6 months. There were 7 secondary outcomes including absenteeism and turnover.
Results Among 198 ICU nurses who were randomized (95 aged ≤30 years [48%] and 115 women [58%]), 182 (92%) completed the trial for the primary outcome. The trial was stopped for efficacy at the scheduled interim analysis after enrollment of 198 participants. The prevalence of job strain at 6 months was lower in the intervention group than in the control group (13% vs 67%, respectively; between-group difference, 54% [95% CI, 40%-64%]; P < .001). Absenteeism during the 6-month follow-up period was 1% in the intervention group compared with 8% in the control group (between-group difference, 7% [95% CI, 1%-15%]; P = .03). Four nurses (4%) from the intervention group left the ICU during the 6-month follow-up period compared with 12 nurses (12%) from the control group (between-group difference, 8% [95% CI, 0%-17%]; P = .04).
Conclusions and Relevance Among ICU nurses, an intervention that included education, role-play, and debriefing resulted in a lower prevalence of job strain at 6 months compared with nurses who did not undergo this program. Further research is needed to understand which components of the program may have contributed to this result and to evaluate whether this program is cost-effective.
Trial Registration ClinicalTrials.gov Identifier: NCT02672072