Background Nurses working in hospice inpatient settings may encounter various emergency situations requiring urgent intervention, however may lack confidence in emergency response skills due to the infrequency of such occurrences in these settings. This project aimed to assess whether a simulation-based training programme focusing on palliative care emergencies conducted in a hospice setting could improve the self-reported confidence and competence of nursing staff.

Methods A training programme was developed to enable nursing professionals to practice clinical skills necessary for recognising and managing palliative care emergencies including opioid induced respiratory depression, catastrophic haemorrhage, anaphylaxis, seizure, and acute airway obstruction. The content was developed by two members of the medical team, overseen by a consultant in palliative medicine. A pre- and post-questionnaire design was employed to collect data. Participants self-reported their confidence and perceived competence in responding to the relevant scenario before and immediately after simulation training and provided free text feedback. Paired T-tests were applied to assess for a change in competence and confidence scores, while free text responses were analysed thematically.

Results Forty healthcare professionals participated across eight simulation sessions. Findings demonstrated a statistically significant increase in the mean scores for both confidence and competence when comparing pre- and post- training (p<0.001). Participants valued the opportunity to develop emergency response skills and recognised the value of simulation as an educational tool. Debrief was perceived to be important for maximising learning and facilitating self-reflection. Many participants noted they had previously underestimated the importance of non-technical skills, but the debriefing process facilitated a deeper appreciation of these skills.

Conclusion Simulation-based training improved both confidence and perceived competence of nursing professionals. Development of simulation-based training programmes specific to palliative care may contribute to the acquisition and development of specialist skills for nursing professionals and may be effective as induction programmes or refresher training.