Authors: (including presenting author): :
Chor YC (1)
Affiliation: :
(1)Accident and Emergency, North District Hospital
Keyword 1: :
Evidence-based practice
Keyword 2: :
Simulation-based training
Keyword 3: :
Wound suturing
Keyword 4: :
Nurse confidence
Keyword 5: :
Nurse competence
Introduction: :
Minor laceration wounds in Accident & Emergency departments (A&E) are managed
by physicians or Advanced Nurse Practitioners. However, due to ongoing healthcare
workforce shortages and rising patient volumes, the responsibility for wound suturing has increasingly shifted to nurses. The A&E training center supports this transition with a one-day suturing skills course that includes theoretical lectures, a hands-on workshop, assessments, and supervised clinical practice. Despite these measures, junior nurses often lack sufficient hands-on experience. To bridge the theory-practice divide and enhance confidence and competence, a simulation-based training (SBT) program for wound suturing has been proposed as an effective strategy.
Objectives: :
1.To enhance nurses’ competence by using A&E Nursing Standard of Care suture
audits form to assess.
2. To enhance nurses’ confidence level by using the 5-points-Likert scale
questionnaire to measure.
3. To develop an Evidence-Based Practice (EBP) by providing a continuous
education and support.
Methodology: :
Project adopted a quasi-experimental, pre-post design to assess the impact of the SBT program on junior registered nurses' confidence and competence in wound suturing. Approximately 15 novice nurses were recruited via purposive sampling. Confidence was measured using a 5-point Likert-scale questionnaire, while competence was evaluated through an A&E Nursing Standard of Care suture audit form, administered before and after the intervention. The program consisted of a 3-hour hands-on workshop led by one physician and three advanced practice nurses, covering technical skills, wound assessment, anesthesia, infection control, and patient communication, followed by a 3-week supervised support period with immediate feedback and debriefing.
Result & Outcome: :
The SBT program resulted in significant improvements in both confidence and
competence among junior registered nurses in the A&E. Pre-test confidence levels for
suturing independently (mean 1.87, SD 0.72), suturing skills (mean 1.67, SD 0.70),
and wound care/education (mean 3.73, SD 0.70) rose post-intervention to means of
3.87, 3.80, and 4.67, respectively, confirmed by paired t-tests with p < 0.001.
Competence, measured by protocol adherence during suturing, improved from a
baseline mean of 54.6% (SD 10.97, range 33–73%) to 92.33% (SD 4.10, range 87–
100%), representing a mean increase of 37.73% (t (14) =15.81, p < 0.001). The SBT program demonstrates an effective, evidence-based strategy for advancing
nursing education in wound management. Implementing a structured three-stage handson
simulation program equips nurses with enhanced skills, fostering greater confidence
and competence for independent suturing.
