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dc.contributor.authorHudson, Krysia
dc.date.accessioned2013-01-28T19:01:40Z
dc.date.available2014-01-06T19:24:14Z
dc.date.issued2012
dc.identifier.urihttp://hdl.handle.net/10713/2328
dc.descriptionUniversity of Maryland, Baltimore. Doctor of Nursing Practice Scholarly Project
dc.description.abstractIntroduction: 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.en_US
dc.description.tableofcontents13 Significance 13 Conceptual Framework 14 Literature Review 16 Current Therapy of Inpatient Insulin Administration 17 Use of Immersive Environments 18 Use of Second Life 19 Simulation and Provider/ Patient Outcomes 24 Summary of Literature Review 27 Methods 28 Restatement of Problem 28 Study Design 28 Sample, Subjects and Setting 28 Data Collection 29 Development 30 GDTA 30 SAGAT 31 Second Life Simulation 32 Measures 32 Demographics 32 Usability 33 SA Score 34Procedures 35 Data Analysis 36 Human Subject Protection 36 Results 37 Demographics 37 Aim 1 - Usability 37 Aim 2 - Decision Making via SA Score 38 Discussion 39 Summary of Findings 39 Aim 1 - Usability 39 Aim 2 - Decision Making via SA Score 41 Limitations 42 Conclusion 43 Plans for Translation and Dissemination 45 Translation 45 Education 45 Policy 46 Practice 46 Dissemination 47 References 49 Tables 71 Figures 77 Appendices 80en_US
dc.language.isoen_USen_US
dc.subjectvirtual environmenten_US
dc.subject.lcshDiabetesen_US
dc.subject.meshInsulin Aspart--administration & dosageen_US
dc.titleUsing Second Life to Improve Insulin Administrationen_US
dc.typedissertationen_US
dc.description.urinameFull Texten_US
refterms.dateFOA2019-02-19T17:53:23Z


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