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Vital for Adult Nurses Update. Phase 1. Provided a diagnostic tool to identify knowledge gaps in the nursing population. Consisted of 14 topic areas with each area assessed by 10 questions. Pass was defined as achieving a mark of 10/10

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phase 1
Phase 1
  • Provided a diagnostic tool to identify knowledge gaps in the nursing population.
  • Consisted of 14 topic areas with each area assessed by 10 questions.
    • Pass was defined as achieving a mark of 10/10
    • Participants were given one attempt at each assessment component.
  • Provided a baseline of current levels of nursing knowledge.
  • Allowed for comparisons across HEFT sites and Bands.
  • 84% of the 3173 registered nurses were enlisted onto the e-learning platform (MOODLE).
  • Approximately 61% of these enrolled population attempted each topic.
    • Site specific attempt rates revealed that Heartlands Hospital consistently had the lowest attempt rates.
    • Solihull Hospital had the highest.
phase 1 pass rates
Phase 1 Pass Rates

Bar chart displaying the overall pass rates across VITAL’s Topics

phase 1 pass rates1
Phase 1 Pass Rates
  • Overall:
    • Evidence that there were gaps in clinical knowledge around key topics.
    • Possibly because specific knowledge is not frequently required on a daily basis.
  • Comparisons by banding:
    • Pass rates generally increased with increasing seniority.
    • Discharge planning, Falls, Mentorship and Nutritional care were exceptions: Band 8s exhibited less knowledge than their juniors.
    • Indication that increasing seniority may result in less frequently utilised skills.
  • The Kruskal Wallis non-parametric test established whether there were significant differences in averages between groups.
  • Revealed significant differences in average scores for diabetes, nutritional care and tissue viability between sites (p < 0.05).
    • Solihull exhibited the lowest averages of the 3 HEFT hospitals.
  • Comparisons across bands revealed significant differences in all topics apart from Discharge Planning and Safer Medicines Management.
    • Trend of increasing average scores with increasing seniority.


    • Supports notion of experiential learning during career progression.
    • Conversely, highlights challenges of transferring knowledge from specialist nurses to their juniors.
conclusions recommendations
Conclusions & Recommendations
  • Provides a proof in principle of how VITAL can highlight key knowledge gaps in the nursing population.
  • Pass mark should be lowered to between 40 and 60% for some modules.
  • Review the way in which specialist nurses disseminate knowledge and facilitate learning
    • Especially regarding Tissue Viability and Diabetes care.
phase 2
Phase 2
  • Provided essential learning materials for practicing nurses in order to refine and supplement knowledge.
  • Assessment consisted of 14 topic, each assessed by 20 questions.
    • Pass was defined as achieving a mark of 20/20.
    • Participants were given unlimited attempts to pass each topic.
    • Inappropriate to compare the scores of individuals who had 1 attempt with individuals who had multiple attempts.
    • Analysis was only possible on the number of attempts it took to pass each topic (get 20/20).
  • 58% of all nurses at HEFT were enrolled onto VITAL.
    • Significant decline from the 84% observed in VITAL Phase 1.
  • Increase in attempt rates as over 70% of enrolled nurses attempted each topic.
    • Similar to Phase 1 Heartlands Hospital still exhibited the lowest attempt rates.
    • Good Hope Hospital exhibited the highest.
phase 2 pass rates1
Phase 2 Pass Rates
  • Overall:
    • Significantly higher pass rates were observed in comparison to Phase 1:
      • Phase 1 ranged from 5% to 62%
      • Phase 2 ranged from 91% to 97%
    • Clear information bias due to participants being given unlimited attempts.
    • Unable to identify any knowledge gaps in the nursing population.
  • NOTE: Pass rates demonstrate a proxy of how many nurses knew 100% of each topic NOT how many nurses knew 60% or 70% or 80% of a topic
  • Attempts taken to complete topics used as an indicator of knowledge.
  • Similar to Phase 1: Tissue viability, Diabetes and Nutritional care were areas of concern.
  • No significant differences across sites.
  • Significant differences across banding for all topics apart from Mentorship.
  • Evidence that knowledge between bands varies in almost all clinical areas.
    • Knowledge increases with increasing seniority.
conclusions and recommendations
Conclusions and Recommendations
  • Number of attempts should be limited:
    • 1 attempt
    • 2 attempts with an average taken
  • Human Resources data on clinical specialty should be included for in depth analysis.
    • Job titles and Clinical area.
phase 3
Phase 3
  • Database will take accurate account of clinical specialties.
  • Evaluative questionnaire will be appended to capture nurse perceptions of VITAL and e-learning.
  • For wider discussion.....
    • Will it be mandatory (for all)?
    • Will it be used for appraisal?
    • How will we support staff who fail?
    • What will the percentage pass mark be set at?
  • Phase 1: One attempt
    • Clear evidence that Diabetes and Tissue Viability are areas of concern.
  • Phase 2: Multiple attempts
    • Attempts indicate similar trends to phase 1.
  • Recommendations
    • Pass mark should be aligned with tertiary education facilities.
    • Attempts should be limited
    • ESR1 data on clinical specialties should be included.
  • Phase 3: BIGGER & BETTER
    • Questionnaire will confer robust analysis.