The FIRST2ACT simulation program improves nursing practice in a rural Australian hospital.

Objective: To measure the impact of the Feedback Incorporating Review and Simulation Techniques to Act on Clinical Trends (FIRST²ACT) simulation program on nursing observations and practice relevant to patient deterioration in a rural Australian hospital. Design: Interrupted time series analysis. Setting: A rural Australian hospital. Participants: All registered nurses (Division 1) employed on an acute medical/surgical ward. Intervention: The FIRST²ACT simulation program. Outcome measures: Appropriate frequency of a range of observations and administration of oxygen therapy. Results: Thirty-four nurses participated (83% of eligible nurses) in the FIRST²ACT program, and 258 records were audited before the program and 242 records after. There were statistically significant reductions in less than satisfactory frequency of observations ( P = 0.009) and pain score charting ( P = 0.003). There was no measurable improvement in the administration of oxygen therapy ( P = 0.143), while the incidence of inappropriate nursing practice for other measures both before and after the intervention was too low to warrant analysis. Conclusion: FIRST²ACT was associated with measurable improvements in nursing practice. [ABSTRACT FROM AUTHOR]