Article Text

Download PDFPDF
Clinical emergencies in inpatient hospice: simulation-based training to improve nursing confidence
  1. Amy Jane Thompson1,2,
  2. Amy Charlotte Boswell1,
  3. Tricia Evans1 and
  4. Beverley Clarke1
  1. 1Compton Care, Wolverhampton, UK
  2. 2St Helens and Knowsley Teaching Hospitals NHS Trust, Prescot, UK
  1. Correspondence to Dr Amy Jane Thompson, Compton Care, Wolverhampton, UK; A.thompson27{at}


Objectives This study aims 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. Eight sessions were conducted. A prequestionnaire and postquestionnaire 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 Findings demonstrated a statistically significant increase in the mean scores for both confidence and competence when comparing pretraining and post-training. 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.

Conclusion Participation in simulation-based training focused on palliative care emergencies in a hospice setting improved both confidence and perceived competence of nursing professionals.

  • Hospice care
  • Education and training
  • End of life care

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Twitter @amyjanethompson

  • Contributors AJT and ACB were responsible for the conception and design of the project. All authors assisted with the creation and evaluation of the simulation programme. Teaching sessions were delivered by AJT and ACB. AJT and ACB conducted the data analysis. All authors contributed to data interpretation and manuscript writing. All authors were responsible for final approval of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.