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Implementing a Three-Dimensional-Printed Simulation Program to Improve Emergency Nurse Competence in Intraosseous Device Use: A Quality Improvement Initiative

Journal of Emergency Nursing·August 1
Emergency MedicinePractice changingIntraosseous AccessVascular Access FailureQuasi-Experimental Study3D-Printed Task TrainerSimulation-Based TrainingMixed

Summary

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What was studied

A quasi-experimental pretest-posttest-follow-up study evaluated a 3-phase '**Crawl-Walk-Run**' simulation program using low-cost 3D-printed tibia/humerus task trainers on 22 emergency nurses' intraosseous (IO) knowledge, skill, confidence, and clinical utilization over 3 months at a Midwestern community hospital.

Key findings

Knowledge (g = 1.31, P < .001) and technical skill (g = 1.23, P < .001) improved significantly and were sustained at 3-month follow-up. Confidence rose post-training (P < .001) but declined modestly by 3 months (P = .43). Nurse-initiated IO insertions went from **0 in the prior year** to **5 first-pass successes within 3 months** post-intervention.

Study limitations

- Very small sample (n = 22) at a single community hospital limits generalizability. - No control group; pre-post design cannot rule out confounders. - Confidence gains were not sustained at 3 months, suggesting booster training may be needed.

Clinical implications

A low-cost 3D-printed IO simulation program can meaningfully boost nurse knowledge, skill, and real-world IO use — consider it as a sustainable training tool for high-acuity, low-occurrence procedures. Schedule periodic booster sessions to help maintain procedural confidence over time.

Related Questions

Explore related topics

What simulation methods best improve nurse competency in low-frequency emergency procedures?How effective is intraosseous access training compared to peripheral IV training for emergency nurses?What strategies help sustain procedural confidence after simulation training over time?

Publication Details

Year
2026
Journal
Journal of Emergency Nursing
Sample Size
n=22
Source
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