Using Second Life to Improve Insulin Administration

Abstract

Introduction: Diabetes is a worldwide epidemic. There are significant safety issues regarding insulin administration of inpatient diabetic populations. Over the past few decades, healthcare provider knowledge of diabetes and diabetes care has not improved. Due to the influx of complex treatments and newer insulins, there is a need to find an improved mechanism to improve knowledge and improve patient safety. Aim: This capstone suggests that nursing practice, in the form of simulation in a virtual immersive environment, like Second Life (SL) is a possible solution. There are two aims of this capstone project. The first aim (Aim 1) is to examine the usability of Second Life as an immersive virtual environment in providing practice with a complex scenario of insulin administration. The second aim is to study nurses clinical decisions concerning insulin administration (Aim 2). Methods: A convenience sample of 12 nurses (>70% of the nurses) from a general medical floor of a local hospital participated in a SL simulation of insulin administration. The nurses evaluated SL for usability using the System Usability Scale (SUS). Decision making of insulin administration was analyzed via measuring Situational Awareness (SA) via Situation Awareness Global Assessment Tool (SAGAT). SAGAT was measured at 2 different simulation freezes during the SL simulation. Results: Analysis was completed using Spearman’s Rho and Chi Square. Needing a score of 70 or above to be considered “usable,” the SL Simulation was not considered “usable” (M= 64.17, SD =16.63). Nurses with more years of practice reported less usability in SL. There was significance found between usability and years of nursing practice (rs = -0.647, p=0.02). As age increased, the total SA score decreased (rs = -0.598, p=0.04). Last, there is an association with a High SA Score (a score above 90%) and nurses working permanent nights. Nurses who work day shift, were more likely to obtain a High SA Score (x2 = 4.29, p=0.04). Implications: Implications for practice include: 1) innovative design and implementation of the SL environments to improve SL usability for all practicing nurses, 2) orientation of experienced nurses to SL and 3) provision of a virtual practice environment for older nurses (especially night nurses) to improve clinical decision making with high alert medications.