Just-in-time training for nurse administration of anesthetic cream application

Abstract

Introduction: Just-In-Time Training (JITT) is an emerging concept in medical education. Providing a brief educational intervention in the form of a video immediately prior to the patient intervention may be an effective method to teach health care providers. In this pilot study, we sought to determine if pediatric emergency department nurses could effectively apply a topical anesthetic to the lower back for lumbar puncture after watching a JITT video.

Methods: Between October 19, 2011 and November 1, 2011, thirty nurses were asked to complete a questionnaire assessing their comfort level on applying a topical anesthetic prior to lumbar puncture. Accuracy of sham cream placement onto the back of an infant mannequin was assessed pre- and post-JITT video. Self-reported comfort levels in cream placement, cream coverage, and overall accuracy of cream placement were compared both pre- and post-JITT intervention.

Results: There was a statistically significant change in the self-reported comfort level of the subjects in applying the cream post-JITT (p < .01). In addition, there was a statistically significant difference in cream coverage after the JITT (p < .01). Furthermore, subjects who were inaccurate with cream placement pre-JITT were more likely to be accurate post-JITT
(p < .01).

Conclusions: JITT is an effective tool in medical education for teaching topical anesthetic cream application onto the back by pediatric emergency department nurses. JITT may offer other possibilities for enhancing medical education.