From Skepticism to Strategy: How Data Proved the Power of Our NRP Skills Carts

By Dr. Eva Dense

As a nurse scientist, one of the most common conversations I have with clinical staff revolves around measuring the impact of our educational efforts. So often, our nurses and leaders in the clinical setting are skeptical about the true effectiveness of things like "rolling skills carts." We feel they make a difference, but we struggle to provide the concrete proof needed to satisfy skeptical leaders or engage busy teams.

I always teach our teams that to show the true value of their work, they need to have outcome metrics.

I’m so excited to share a story of what happens when a brilliant educator does exactly that.

A Nurse Professional Development practitioner from the Pacific Northwest, decided to formally measure the impact of her Neonatal Resuscitation Program (NRP) skills cart at a Family Birth Center. Along with her colleague, she created a survey to capture data from nurses before and after the training.

I had the privilege of performing the statistical analysis of her data, and the results weren't just positive—they were a complete validation of her work and a strategic roadmap for the future.

The Result: "Does this even work?"

Yes. Unquestionably, yes.

The most powerful finding was the statistically significant increase in overall confidence among the nursing staff.

• In the Labor and Delivery (L&D) department, confidence scores skyrocketed (p < 0.001).

• In the Mother Baby Unit (MBU), we also saw a significant jump in confidence (p = 0.019).

  
  

But a p-value only tells us the change was real. It doesn't tell us how big that change was. That's where effect size comes in. For the MBU group, the effect size (Cohen's d) for this confidence boost was 1.41.

To put that in perspective, in statistics, an effect size of 0.8 is considered "large." Our result of 1.41 is massive. It proves the change wasn't just statistically real; it was a practically huge improvement.

This data provides a powerful narrative. We can now say with statistical certainty that these educational interventions are highly effective at improving a nurse's self-assurance in handling high-stakes neonatal emergencies.

The Real Win: From "Effective" to "Efficient"

But the data did more than just prove the cart was working. It showed the educator exactly where to focus her energy to be more efficient.

1. It Showed Who to Focus On:

   In the L&D unit, we learned that while more experienced nurses started with higher confidence, it was the less experienced nurses who had the greatest increase in confidence after the training. This is a crucial insight. It means the program is successfully "closing the confidence gap" between novice and senior staff and is an invaluable tool for onboarding.

   
   

2. It Showed What to Focus On:

   In the MBU, the data gave us a precise target list. The most significant improvements were in three specific competencies: Room Safety Check (p = 0.025), Beginning Positive Pressure Ventilation (PPV) (p = 0.031), and Closed-Loop Communication (p = 0.001). The educator no longer has to guess where her team is weakest; she can now dedicate her limited time to targeted drills on these specific skills.

   
   

This is the real power of outcome metrics. We’ve moved from "let's review everything" to "let's focus our energy here."

The "So What?"

This study, born from an educator's desire to prove her value, did more than just validate a skills cart.

• It provided a powerful narrative to present to skeptical leaders, backed by undeniable data.

• It transformed a general education tool into a targeted, strategic asset that saves the educator time and addresses specific, proven gaps in skills and confidence.

• It provided a measurable return on investment, giving a director the evidence needed to advocate for expanding this successful model across the entire system.

  
  

This is what it looks like to move from "I think this works" to "I know this works." And that data-driven confidence is what truly transforms nursing practice.