NURSING CONSULTATION FOR INSULIN USE: CONSTRUCTION AND VALIDITY OF A SIMULATION SCENARIO

Schlosser, Christian Nelson; Silva, Juliany Lino Gomes; Andrade, Silmara Nunes; Galindo Neto, Nelson Miguel; Oliveira, Flávia de; Lima, Maria Helena Melo; Trevisan, Danilo Donizetti

doi:10.1590/1980-265X-TCE-2023-0097en

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Original article • Texto contexto - enferm. 32 • 2023 • https://doi.org/10.1590/1980-265X-TCE-2023-0097en copy

NURSING CONSULTATION FOR INSULIN USE: CONSTRUCTION AND VALIDITY OF A SIMULATION SCENARIO

CONSULTA DE ENFERMERÍA PARA EL USO DE INSULINA: CONSTRUCCIÓN Y VALIDACIÓN DE UN ESCENARIO DE SIMULACIÓN

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To build and validate a clinical simulation scenario for teaching students about nursing consultations for people with type 2 Diabetes Mellitus in initial insulin use.

Method:

A methodological study, carried out in a higher education institution in Minas Gerais, Brazil, between December 2021 and November 2022. The steps taken involved scenario construction, validity by 16 judges and scenario testing by 30 students. The conceptual model proposed by Jeffries and International Nursing Association for Clinical Simulation in Learning guidelines were followed to elaborate the scenario.

Results:

The scenario was called “Nursing consultation for teaching initial insulin use to people with type 2 Diabetes Mellitus”. The scenario and the checklist for its validity were constructed, then, face and content validity was performed. The final validated version consisted of seven conceptual components (context, background, design, simulated experience, facilitator actions and educational strategy, participants and expected results). The overall value of the Content Validity Index was 0.98. High comprehensibility was noted by the target audience when testing the scenario.

Conclusion:

The scenario obtained adequate validity and comprehensibility. Using this teaching tool can contribute to the training of future nurses regarding the consultation for patients using insulin.

DESCRIPTORS:
Simulation Training; Insulin; Diabetes Mellitus, Type 2; Office Nursing; Validation Study

Variables	n (%)*	I-CVI^†
1. Objective
1.1 Contents are consistent with the scenario	15 (93.75)	0.94
clinical simulation’s objective	16 (100)	1.00
1.2 Learning objectives are clear and concise	16 (100)	1.00
1.3 Scenario content facilitates critical thinking	16 (100)	1.00
1.4 The information presented is scientifically correct	15 (93.75)	0.94
1.6 The information presented in the scenario can adequately cover the content on insulin use	16 (100)	1.00
1.7 Information/content is important for the quality of care provided	16 (100)	1.00
1.8 The clinical simulation scenario’s objective invites and/or instigates to adopt behavioral changes and awaken students’ attitudes towards insulin use	16 (100)	1.00
2. Structure and presentation
2.1 Scenario script is appropriate for nursing students	16 (100)	1.00
2.2 Language used is easy for students to understand	16 (100)	1.00
2.3 The scenario has an attractive visual that keeps students’ attention	16 (100)	1.00
2.4 Data are presented in a structured and objective manner	16 (100)	1.00
2.5 How the scenario is presented contributes to student learning	16 (100)	1.00
2.6 Contains evidence needed to promote insulin education	14 (87.5)	0.87
2.7 Contextual details provide clues based on desired outcomes	16 (100)	1.00
2.8 Patient profile provides sufficient data to make a clinical judgment	16 (100)	1.00
2.9 Pages or sections are organized	16 (100)	1.00
3. Relevance
3.1 Scenario script allows the transfer of knowledge and learning regarding insulin management	16 (100)	1.00
3.2 The theme portrays key aspects that must be reinforced	16 (100)	1.00
3.3 The model allows the transfer and generalization of learning to different contexts	16 (100)	1.00
3.4 Scenario script proposes construction of knowledge	15 (93.75)	0.94
3.5 Can be used by health professionals/or educators	15 (93.75)	0.94
3.6 The clinical simulation scenario in insulin management can circulate in the scientific community of the area	15 (93.75)	0.94

Participants’ suggestions	Changes performed
Committee of judges
Objective	Include in the expected actions checklist: - Importance of aspirating insulin in a bright environment; - Knowledge of the syringe and the scale of measurement units; - Reinforce the importance of hand hygiene; - Advise that insulin is dispensed free of charge by the unified health system; - Include more information about the rotation; - Break down the disposal of needles and insulin bottles; - Reinforce the time (five to ten seconds) before removing the needle from the skin after application.
Structure and presentation	Include more line spacing to make the scenario easier to read.
Relevance	No suggestions
Students (target audience)
Item before the change	Item after the change
Based on this, together, you and the nursing intern should teach and guide Pedro regarding initial insulin use	Based on that, together, you and the nursing intern should teach and guide Mr. Pedro regarding initial insulin use. It should be noted that its objective will be to carry out nursing consultation for Mr. Pedro, in order to teach him how to use insulin correctly and safely, as previously presented in the objectives.
c. Explain the insulin absorption time at each application site, considering the factors that may interfere.	c. Explain the time of insulin’s action depending on the type of insulin, application site and activities of daily living of users.
d. Plan the rotation of application sites considering the number of applications per day, activities of daily living, physical activity and other factors that may influence the speed of insulin absorption.	d. Plan the rotation of application sites considering the number of applications per day, activities of daily living and other factors that may influence insulin action.
e. Examine the application site and the size of the needle used to define whether or not to perform the subcutaneous fold.	e. Define whether or not to perform the subcutaneous fold, depending on the size of the needle and the site of insulin application.

Universidade Federal de Santa Catarina, Programa de Pós Graduação em Enfermagem Campus Universitário Trindade, 88040-970 Florianópolis - Santa Catarina - Brasil, Tel.: (55 48) 3721-4915 / (55 48) 3721-9043 - Florianópolis - SC - Brazil
E-mail: textoecontexto@contato.ufsc.br

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[1] CORRESPONDING AUTHOR
Danilo Donizetti Trevisan ddtrevisan@ufsj.edu.br