"Our Care through our eyes": impact of a co-produced digital education programme on nurses’ knowledge, confidence and attitudes in providing care for children and young people who have self-harmed: a mixed-methods study in the UK

Objectives: 1. To determine the impact of a digital educational intervention on the knowledge, attitudes, confidence and behavioural intention of registered children’s nurses working with Children and Young People (CYP) admitted with self-harm 2. To explore the perceived impact, suitability and usefulness of the intervention. Intervention: A digital educational intervention that had been co-produced with CYP service users, registered children’s nurses, and academics. Setting: A prospective, uncontrolled, intervention study with pre and post-intervention measurement, conducted at a large acute NHS Trust in the UK. Participants: From a pool of 251 registered children’s nurses, 98 participants were recruited to complete the intervention (response rate = 39%). At follow-up, 52% of participants completed the post-intervention questionnaire, with 65% (n=33) of those reporting to have completed the digital educational intervention. Primary Outcome measures: Attitudes towards self-harm in CYP was measured using a 13 item questionnaire; knowledge of self-harm in CYP was measured through an adapted 12 item questionnaire; confidence in different areas of practice was measured through Likert scale responses; Self-efficacy for working with CYP who have self-harmed was measured through an adapted version of the Self-efficacy Towards Helping (SETH) scale; Clinical behavioural intention was measured by the Continuing Professional Development Reaction Questionnaire. Semi-structured interviews were undertaken with a purposive sample of participants. Results: For those who completed the intervention (n=33), improvements were observed in knowledge (Effect size, ES: 0.69), confidence, and in some domains relating to attitudes (Effectiveness domain- ES: 0.49), and clinical behavioural intention (Belief about consequences-ES:0.49; Moral Norm-ES: 0.43; Beliefs about capability-ES: 0.42). Qualitative findings suggest participants experienced skill development, feelings of empowerment, and reflection on own practice. Conclusions: The effect of the intervention is promising and demonstrates the potential it has in improving registered children’s nurse’s knowledge, confidence and attitudes. However, further testing is required to confirm this.