Practice Improvement|Articles in Press

Setting the Stage: Innovation in Port Access Education for Pediatric Emergency Nurses

Published:March 03, 2023DOI:



      Pediatric port access can be challenging in the emergency department; however, it must be performed promptly and safely. Port education for nurses traditionally includes procedural practice on adult-size, tabletop manikins, which lacks the situational and emotional aspects inherent in pediatrics. The purpose of this foundational study was to describe the knowledge and self-efficacy gain from a simulation curriculum that promotes effective situational dialogue and sterile port access technique, while incorporating a wearable port trainer to enhance simulation fidelity.


      An educational intervention impact study was conducted using a curriculum integrating a comprehensive didactic session with simulation. A unique element included a novel port trainer worn by a standardized patient, along with a second actor portraying a distressed parent at the bedside. Participants completed precourse and postcourse surveys on the day of simulation and a 3-month follow-up survey. Sessions were video recorded for review and content analysis.


      Thirty-four pediatric emergency nurses participated in the program and demonstrated an overall increase in knowledge and self-efficacy with port access that was sustained at the 3-month follow-up. Data revealed positive feedback regarding the participants’ simulation experience.


      Effective port access education for nurses requires a comprehensive curriculum integrating procedural aspects and situational techniques to address the components of a true port access experience involving pediatric patients and families. Our curriculum successfully combined skill-based practice with situational management, and promoted nursing self-efficacy and competence with port access in the pediatric population.

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      Denise Downey, Member, Mayflower Chapter, is Nursing Professional Development Specialist, Emergency Services, Boston Children’s Hospital, Boston, MA. Twitter: @DDowneyRN. ORCID identifier:


      Kelsey Graber is PhD Student, Center for Research on Play in Education, Development, and Learning, University of Cambridge, Cambridge, UK. ORCID identifier:


      Debra Lajoie is Director, Nursing Research Medical, Surgical, Behavioral Health and Emergency Programs, Boston Children’s Hospital, Boston, MA. ORCID identifier:


      Lori Newman is Director of Professional Development in Education, Assistant Professor of Pediatrics, Harvard Medical School, Boston Children’s Hospital, Boston MA. ORCID identifier:


      Peter Weinstock is Executive Director, Immersive Design Systems, Senior Associate, Critical Care Medicine, Chair in Pediatric Simulation, Associate Professor, Harvard Medical School, Boston Children’s Hospital, Boston, MA. ORCID identifier: