Determining the Effects of Training on Nursing Students Using Two Different Methods for Maintaining Fluid and Electrolyte Balance in a Child Trapped Under a Collapse

Overview

The aim of this randomized controlled trial is to determine the effects of two different training methods on nursing students regarding the maintenance of fluid and electrolyte balance in a child trapped under rubble. The sample consisted of 69 participants (conventional training group: 23; simulation group: 23; control group: 23). The traditional education group received training on nursing interventions related to fluid and electrolyte balance in children trapped under rubble in a single theoretical module lasting a total of 90 minutes. The simulation group, however, received the same training in two modules-combining theoretical instruction with a simulation scenario-over a total of 270 minutes. The control group received no training. Data were collected in two phases: a pre-test and a post-test; the post-tests were administered one month after the pre-test.

Mass disasters such as earthquakes have more severe and long-lasting biopsychosocial effects on children, whose developmental processes are ongoing and whose stress coping mechanisms are more limited compared to adults. In particular, building collapses pose a life-threatening danger to children. Crush injuries in children trapped under debris and the resulting physiological changes include disruption of fluid-electrolyte balance. Fluid-electrolyte imbalance resulting from tissue damage and Crush Syndrome can lead to life-threatening complications such as metabolic issues and acute kidney failure. Therefore, it is essential for pediatric nurses to possess the knowledge and skills necessary for caring for children in disaster conditions to ensure effective care can be maintained. This necessity highlights the importance of incorporating such knowledge and skills into the pediatric nursing undergraduate education curriculum. It is crucial for pediatric nursing students to be adequately prepared to handle these complex and high-risk clinical situations they may encounter during disaster conditions, as this directly impacts the quality of care. However, factors such as the limited likelihood of encountering such cases in real clinical settings and the high workload and time constraints in clinical practice areas necessitate the use of alternative educational methods to help students develop their knowledge and skills. Traditional teaching methods, which are among the various approaches, are mostly teacher-centered and limited to question-and-answer sessions. For this reason, the use of simulation-based training methods has become increasingly widespread in recent years, particularly in the field of pediatric care. This study included 69 students enrolled at the Faculty of Nursing at Selcuk University. Participants were divided into groups using sealed envelopes labeled SG, KEG, and KG. Prior to the study, the sample size for each group was calculated based on the effect size (d=0.80), power (.95), and alpha error (.05), resulting in a total of 57 participants. To prevent potential sampling issues that might arise during the study (such as participants not wishing to continue), the sample size was increased by 20%, resulting in a total of 69 nursing students (conventional education group: 23; simulation group: 23; control group: 23). The traditional education group received training on nursing interventions related to the fluid-electrolyte balance of a child trapped under debris in a single theoretical module lasting a total of 90 minutes. The simulation group, however, received the same training through both theoretical instruction and simulation scenario experience, in two modules totaling 270 minutes. The control group received no training. Data were collected using an information form, a form assessing nursing students' nursing practices aimed at maintaining fluid and electrolyte balance in a child trapped under debris, and the Clinical Decision-Making Confidence and Anxiety Scale in Nursing. Validity and reliability studies for these scales were conducted on the Turkish population.