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Ranjbar F, Sharif-Nia H, Shiri M, Rahmatpour P. The effect of spaced E-Learning on knowledge of basic life support and satisfaction of nursing students: a quasi-experimental study. BMC MEDICAL EDUCATION 2024; 24:537. [PMID: 38750506 PMCID: PMC11097522 DOI: 10.1186/s12909-024-05533-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 05/08/2024] [Indexed: 05/18/2024]
Abstract
AIM Cardiopulmonary resuscitation (CPR) training is essential for all students, especially nursing students. One of the educational approaches to creating long-term learning in inclusive is spaced learning. Spaced learning consists of three or more training sessions in which information is presented over time and at intervals. The present study was conducted to investigate the effect of basic life support (BLS) training through spaced E-learning on the knowledge and satisfaction of nursing students. METHODS In this quasi-experimental study with two groups, 106 undergraduate nursing students of Alborz University of Medical Sciences in Iran participated. The control group (n = 47) received BLS training with massed E-learning in one three-hour session, and the intervention group (n = 59) received spaced E-learning in three one-hour sessions. An electronic questionnaire including demographic information and a pre-test of BLS knowledge were sent to both groups. Also, immediately after receiving the training, two weeks later and one month later, they completed a post-test of BLS knowledge. Students were asked to indicate their level of satisfaction with the provided education by completing the SLS-OLE. RESULTS The post-test scores immediately after, two weeks later, and one month later of the intervention group were higher than the control group. The results of repeated measurement ANOVA showed that the score changes of knowledge are significant over time (p < 0.001), the number of sessions (p < 0.001), and the interactive effect of them (p < 0.001). There was no statistically significant difference in the level of satisfaction with education in both groups. CONCLUSION Based on the results, BLS training in both groups increased the knowledge of BLS. however, the increase in knowledge and its retention was higher in the intervention group that received the training in spaced learning.
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Affiliation(s)
- Fataneh Ranjbar
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| | - Hamid Sharif-Nia
- Education Development Center, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Nursing, Amol Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Maryam Shiri
- Department of Medical Education, Alborz University of Medical Sciences, Karaj, Iran
- School of Nursing, Alborz University of Medical Sciences, Karaj, Iran
| | - Pardis Rahmatpour
- School of Nursing, Alborz University of Medical Sciences, Karaj, Iran.
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Lu Z, Wang W, Florez-Arango JF, Seo JH, Hamilton DK, Wells-Beede E. A Framework to Develop an Immersive Virtual Reality Simulation Tool for Postpartum Hemorrhage Management Nurse Training. Nurs Educ Perspect 2024; 45:189-191. [PMID: 36881514 DOI: 10.1097/01.nep.0000000000001112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
ABSTRACT Postpartum hemorrhage (PPH) is the leading cause of maternal mortality and morbidity. Effective nurse training for PPH management can reduce negative health impacts on childbearing women. This article discusses a framework for the development of an innovative immersive virtual reality simulator for PPH management training. The simulator should consist of: 1) a virtual world, including virtual physical and social environments, and simulated patients, and 2) a smart platform, providing automatic instructions, adaptive scenarios, and intelligent performance debriefing and evaluations. This simulator will provide a realistic virtual environment for nurses to practice PPH management and promote women's health.
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Affiliation(s)
- Zhipeng Lu
- About the Authors Zhipeng Lu, PhD, MArch, is associate director, Center for Health Systems & Design, and assistant professor, Department of Architecture, Texas A&M University, College Station, Texas. Wenjin Wang, MDes, is a PhD student, Department of Architecture, Texas A&M University. Jose Fernando Florez-Arango, MD, MS, PhD, is assistant professor, Department of Population Health Sciences, Weill Cornell Medicine, New York, New York. Jinsil Hwaryoung Seo, PhD, is director, Institute for Applied Creativity; associate professor, School of Performance, Visualization & Fine Art; and fellow, Center for Health Systems & Design, Texas A&M University. D. Kirk Hamilton, PhD, Emeritus FAIA & FACHA, FCCM, is professor emeritus, Department of Architecture, and fellow, Center for Health Systems & Design, Texas A&M University. Elizabeth Wells-Beede, PhD, RN, C-EFM, CHSE-A, CNE, ACUE, FAAN, is clinical associate professor, School of Nursing, and fellow, Center for Health Systems & Design, Texas A&M University. This study is supported by the T3 Grant sponsored by Texas A&M University. For more information, contact Dr. Lu at
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Hemann M, Carver R, Sanchez A, Carter B, McGee A. Be a Champion! An Approach to Medical Emergency Response In Situ Simulations in the Outpatient Setting. J Nurses Prof Dev 2024; 40:139-143. [PMID: 38687708 DOI: 10.1097/nnd.0000000000001041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
Results from a needs assessment conducted by nursing professional development practitioners across several clinics in the Midwest showed current educational methods to prepare for medical emergencies were insufficient. A champion model was used to complete in situ medical emergency response simulations. This proved to be an effective method for staff preparation when resources were limited and identified opportunities for practice improvement.
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Haynes JC, Rettedal SI, Ushakova A, Perlman JM, Ersdal HL. How Much Training Is Enough? Low-Dose, High-Frequency Simulation Training and Maintenance of Competence in Neonatal Resuscitation. Simul Healthc 2024:01266021-990000000-00112. [PMID: 38445834 DOI: 10.1097/sih.0000000000000783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
INTRODUCTION Facemask ventilation is a crucial, but challenging, element of neonatal resuscitation.In a previously reported study, instructor-led training using a novel neonatal simulator resulted in high-level ventilation competence for health care providers (HCPs) involved in newborn resuscitation. The aim of this study was to identify the optimal frequency and dose of simulation training to maintain this competence level. METHODS Prospective observational study of HCPs training through 9 months. All training was logged. Overall ventilation competence scores were calculated for each simulation case, incorporating 7 skill elements considered important for effective ventilation.Overall scores and skill elements were analyzed by generalized linear mixed effects models using frequency (number of months of 9 where training occurred and total number of training sessions in 9 months) and dose (total number of cases performed) as predictors. Training loads (frequency + dose) predictive of high scores were projected based on estimated marginal probabilities of successful outcomes. RESULTS A total of 156 HCPs performed 4348 training cases. Performing 5 or more sessions in 9 months predicted high global competence scores (>28/30). Frequency was the best predictor for 4 skill elements; success in maintaining airway patency and ventilation fraction was predicted by performing training in, respectively, 2 and 3 months of 9, whereas for avoiding dangerously high inflating pressures and providing adequate mask seal, 5 and 6 sessions, respectively, over the 9 months, predicted success. Skills reflecting global performance (successful resuscitation and valid ventilations) and ventilation rate were more dose-dependent. CONCLUSIONS Training frequency is important in maintaining neonatal ventilation competence. Training dose is important for some skill elements. This offers the potential for individualized training schedules.
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Affiliation(s)
- Joanna C Haynes
- From the Department of Anaesthesia (J.C.H., H.L.E.), Stavanger University Hospital, Stavanger, Norway; Faculty of Health Sciences (J.C.H., S.I.R., H.L.E.), University of Stavanger, Stavanger, Norway; Department of Paediatrics (S.I.R.), Stavanger University Hospital, Stavanger, Norway; Department of Biostatistics (A.U.), Stavanger University Hospital, Stavanger, Norway; and Department of Pediatrics (J.M.P.), Weill Cornell Medicine, New York, NY
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Pongtriang P, Soontorn T, Sumleepun J, Chuson N. Emergency Scenario-Based Training Curriculum Development: Enhancement of Caregivers for the Elderly' Emergency Assistance Competency in a Rural Thai Community. SAGE Open Nurs 2024; 10:23779608241255635. [PMID: 38770423 PMCID: PMC11104023 DOI: 10.1177/23779608241255635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 03/31/2024] [Accepted: 04/28/2024] [Indexed: 05/22/2024] Open
Abstract
Background Caregivers for the elderly are a critical component of the health care system, especially in rural communities. They play a crucial role, assisting older people in confronting emergency illnesses. Objective The study describes the process of developing an emergency scenario-based training curriculum (ESBTC) for caregivers of the elderly, focusing on geriatric life-threatening surveillance and emergency assistance (GLTSEA) in rural communities. Methods The descriptive qualitative research utilized for developing the ESBTC followed Karn's six steps of curriculum development: (1) needs assessment, (2) targeted needs assessment, (3) goals and objectives, (4) educational strategies, (5) implementation, and (6) evaluation and feedback. The research sample comprised community representatives engaged in providing care during emergency illnesses, emergency experts, and health care providers. A group discussion and focus group were conducted along with semi-structured interviews. The data were analyzed by content analysis following Creswell's six steps. Results The results revealed problems and needs related to the care and management of emergency illnesses in rural communities. Five main themes emerged, including insufficient knowledge, difficulties in communication, mindfulness and self-confidence, Unable to assess the initial symptoms, and a need for skills development. In the development step, the curriculum focused on skill development and continued follow-up to ensure necessary skills, such as providing basic life support, using automated external defibrillators, through training scenarios. In the evaluation step, the participants indicated that their emergency assistance skills had improved. The six main themes that emerged regarding the training continuity, courses, and competencies needed to support the emergency system for caregivers were benefits and value, competence enhancements, upstreaming confidence, sustainable development, challenges in curriculum development, and effective strategies. Conclusions The ESBTC combines community-based and realistic scenarios, involving the participation of community stakeholders. It is crucial to gather community feedback and needs assessments to formulate potential strategies as part of the curriculum.
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Affiliation(s)
- Praditporn Pongtriang
- Department of Adult and Elderly Nursing, Faculty of Nursing, Suratthani Rajabhat University, Surat Thani, Thailand
| | - Thassanee Soontorn
- Department of Adult and Elderly Nursing, Faculty of Nursing, Suratthani Rajabhat University, Surat Thani, Thailand
| | - Jaruwat Sumleepun
- Department of Emergency and Accident, Suratthani Hospital, Surat Thani, Thailand
| | - Noawarat Chuson
- Department of Emergency and Accident, Vibhavadi Hospital, Surat Thani, Thailand
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Oermann MH, VanRiel YM, Stieve DE, Vermeesch CA, Crane PC, Kratovil A, Baker M, Guerra DS, Chamness J, Saeed BA, Rogers V, Flicker JM, Patterson CM. Developing competency of nursing students in cardiopulmonary resuscitation using Resuscitation Quality Improvement technology. Int J Nurs Educ Scholarsh 2024; 21:ijnes-2023-0122. [PMID: 38680068 DOI: 10.1515/ijnes-2023-0122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 04/12/2024] [Indexed: 05/01/2024]
Abstract
OBJECTIVES This study examined the outcomes of training nursing students in CPR skills using the Resuscitation Quality Improvement (RQI) program. METHODS Nursing students (n=2,193) in 12 schools across the United States participated in this study. Students performed compressions and bag-masked ventilation on adult and infant manikins using the RQI simulation station without and then with feedback on their performance. RESULTS With real-time, objective feedback from the RQI simulation station, students' performance of CPR skills improved, and they retained their skills over time. CONCLUSIONS The RQI program and methodology of feedback is effective for training nursing students to be competent in CPR skills, essential for safe patient care. Nursing and other healthcare professions programs should consider adopting the RQI program for students to develop competency in CPR.
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Affiliation(s)
| | - Yolanda M VanRiel
- Department of Nursing, North Carolina Central University, Durham, NC, USA
| | - Debra E Stieve
- College of Nursing, Michigan State University, East Lansing, MI, USA
| | - Carol A Vermeesch
- College of Nursing, Michigan State University, East Lansing, MI, USA
| | - Patrick C Crane
- College of Nursing, Michigan State University, East Lansing, MI, USA
| | - Amanda Kratovil
- College of Nursing, Purdue University Northwest, Hammond, IN, USA
| | - Manisa Baker
- College of Nursing, Purdue University Northwest, Hammond, IN, USA
| | - Donna S Guerra
- College of Nursing, University of Alabama Huntsville, Huntsville, AL, USA
| | - Joseph Chamness
- College of Nursing, University of Alabama Huntsville, Huntsville, AL, USA
| | - Bushra Ahmad Saeed
- Division of Nursing, Allied Health, Life and Physical Sciences, University of the District of Columbia Community College, Washington DC, USA
| | - Vonda Rogers
- Division of Nursing, Allied Health, Life and Physical Sciences, University of the District of Columbia Community College, Washington DC, USA
| | - Joy M Flicker
- John and Karen Arnold School of Nursing, Alvernia University, Reading, PA, USA
| | - C Marie Patterson
- Physician Assistant Studies, Middle Tennessee State University, Murfreesboro, TN, USA
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Ziapour A, Hatami Garosi V, Tamri Y, Ghazvineh S, Azizi A. Investigating the outcomes of cardiopulmonary resuscitation and factors affecting it: A cross-sectional study at Dr. Moaven Hospital, Sahneh City from 2014 to 2021. Health Sci Rep 2023; 6:e1493. [PMID: 37599656 PMCID: PMC10435728 DOI: 10.1002/hsr2.1493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 07/16/2023] [Accepted: 08/01/2023] [Indexed: 08/22/2023] Open
Abstract
Background and Aims Cardiopulmonary resuscitation (CPR) is referred to an attempt to maintain the respiratory system and blood circulation active to oxygenate the body's important organs until the heart and blood circulation system return to normal. CPR results are influenced by a variety of circumstances and factors. The purpose of this study was to look into the outcomes of CPR and the factors that influence them at the Dr. Moaven Hospital in Sahneh. Methods This cross-sectional descriptive study was carried out retrospectively from the start of 2014 to the start of 2021. Kermanshah University of Medical Sciences provides hospitals with a two-page form for data collection. After entering the data into SPSS24, descriptive and inferential statistical tests were applied to analyze the results. Results Out of 497 patients who referred to Dr. Moaven Hospital in Sahne City, 280 were men and 217 were women, with a resuscitation success rate of 22.5% in men and 23.5% in women. CPR was conducted on 63.2% of patients in the emergency department, with 22.2% of them having successful CPR. The existence of the underlying disease had a statistically significant link with the outcomes of CPR (p = 0.007). The most prevalent cause for visit was cardiorespiratory arrest (30.6%), and there was no statistically significant difference between the diagnostic and reason for visit and the outcome of resuscitation, according to the χ 2 test. Conclusion According to the findings of this study, increasing age and duration of CPR, the existence of underlying diseases, and the absence of shockable rhythms all reduce the likelihood of success in CPR.
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Affiliation(s)
- Arash Ziapour
- Cardiovascular Research Center, Health Institute, Imam‐Ali HospitalKermanshah University of Medical SciencesKermanshahIran
| | - Vahid Hatami Garosi
- Student Research CommitteeKermanshah University of Medical SciencesKermanshahIran
| | - Yasaman Tamri
- Kermanshah University of Medical SciencesKermanshahIran
| | | | - Ali Azizi
- Department of Community Medicine, Faculty of MedicineKermanshah University of Medical SciencesKermanshahIran
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Marks S, Shaffer L, Zehnder D, Aeh D, Prall DM. Under pressure: What individual characteristics lead to performance of high-quality chest compressions during CPR practice sessions? Resusc Plus 2023; 14:100380. [PMID: 37035444 PMCID: PMC10074238 DOI: 10.1016/j.resplu.2023.100380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
Abstract
Aim Despite well-established protocols for cardiopulmonary resuscitation training, performance during real-life cardiac arrests can be suboptimal. Understanding personal characteristics which could influence performance of high-quality chest compressions could provide insight into the practice-performance gap. This study examined chest compression performance, while employing feedback and introducing code team sounds as an anxiety-inducing factor in registered nurses using a cardiopulmonary resuscitation training manikin. Methods Participants included 120 registered nurses with basic life support certification randomized to one of the following groups: no feedback and no code team sounds, feedback without code team sounds, or feedback with code team sounds. Chest compression sessions occurred at baseline, 30-days and 60-days. Demographic variables and anxiety level were also collected. The primary outcome was chest compression performance, defined as average percent of time with correct rate and percent with correct depth as captured by the defibrillator. Statistical analysis included linear mixed effects analysis. Results The effect of feedback on chest compression performance depended on the value of other parameters. The benefit of feedback on the primary outcome depended on: age, with feedback less beneficial among older participants (p = 0.0413); and time, with feedback more beneficial with repetition (p = 0.011). These interactions also affected the outcome percent of time with correct compression depth. Increased anxiety was associated with decreased percent correct compression depth (p < 0.001). Conclusion Feedback emerged as important in determining chest compression performance. Chest compression quality was limited by the performer's age and anxiety level. Future research should focus on identifying factors related to individual characteristics which may influence chest compression performance.
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Li T, Essex K, Ebert D, Levinsky B, Gilley C, Luo D, Alper E, Barbara P, Rolston DM, Berkowitz J, Chakraborty P. Resuscitation Quality Improvement® (RQI®) HeartCode® Complete Program Improves Chest Compression Rate in Real World Out-of Hospital Cardiac Arrest Patients. Resuscitation 2023; 188:109833. [PMID: 37178900 DOI: 10.1016/j.resuscitation.2023.109833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/05/2023] [Accepted: 05/08/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND The Resuscitation Quality Improvement® (RQI®) HeartCode© Complete program is designed to enhance cardiopulmonary resuscitation (CPR) training by using real-time feedback manikins. Our objective was to assess the quality of CPR, such as chest compression rate, depth, and fraction, performed on out-of-hospital cardiac arrest (OHCA) patients among paramedics trained with the RQI program vs. paramedics who were not. METHODS AND RESULTS Adult OHCA cases from 2021 were analyzed; 353 OHCA cases were classified into one of three groups: 1) 0 RQI®-trained paramedics, 2) 1 RQI®-trained paramedic, and 3) 2-3 RQI®-trained paramedics. We reported the median of the average compression rate, depth, and fraction, as well as percent of compressions that were between 100 to 120/minute and percent of compressions that were 2.0 to 2.4 inches deep. Kruskal-Wallis Tests were used to assess differences in these metrics across the three groups of paramedics. Of 353 cases, the median of the average compression rate/minute among crews with 0, 1, and 2-3 RQI®-trained paramedics was 130, 125, and 125, respectively (p=0.0032). Median percent of compressions between 100 to 120 compressions/minute was 10.3%, 19.7%, and 20.1% among crews with 0, 1, and 2-3 RQI®-trained paramedics, respectively (p=0.0010). Median of the average compression depth was 1.7 inches across all three groups (p=0.4881). Median compression fraction was 86.4%, 84.6%, and 85.5% among crews with 0, 1, and 2-3 RQI-trained paramedics, respectively (p=0.6371). CONCLUSIONS RQI® training was associated with statistically significant improvement in chest compression rate, but not improved chest compression depth or fraction in OHCA.
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Affiliation(s)
- Timmy Li
- Department of Emergency Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 300 Community Drive, Manhasset, NY, USA; Department of Emergency Medicine, North Shore University Hospital, Northwell Health, 300 Community Drive, Manhasset, NY, USA.
| | - Kyle Essex
- Center for Emergency Medical Services, Northwell Health, 15 Burke Lane, Syosset, NY, USA
| | - David Ebert
- Center for Emergency Medical Services, Northwell Health, 15 Burke Lane, Syosset, NY, USA
| | - Brian Levinsky
- Center for Emergency Medical Services, Northwell Health, 15 Burke Lane, Syosset, NY, USA
| | - Charles Gilley
- Feinstein Institutes for Medical Research, Northwell Health, 350 Community Drive, Manhasset, NY, USA
| | - Dee Luo
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra Blvd, Hempstead, NY, USA
| | - Eric Alper
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra Blvd, Hempstead, NY, USA
| | - Paul Barbara
- Department of Emergency Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 300 Community Drive, Manhasset, NY, USA; Center for Emergency Medical Services, Northwell Health, 15 Burke Lane, Syosset, NY, USA; Department of Emergency Medicine, Staten Island University Hospital, Northwell Health, 475, Seaview Ave, Staten Island, NY, USA
| | - Daniel M Rolston
- Department of Emergency Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 300 Community Drive, Manhasset, NY, USA; Department of Emergency Medicine, North Shore University Hospital, Northwell Health, 300 Community Drive, Manhasset, NY, USA
| | - Jonathan Berkowitz
- Center for Emergency Medical Services, Northwell Health, 15 Burke Lane, Syosset, NY, USA
| | - Priam Chakraborty
- Department of Emergency Medicine, Long Island Jewish Medical Center, Northwell Health, 270-05 76(th) Ave, Queens, NY, USA
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McCaw JM, Yelton SEG, Tackett SA, Rapal RMLL, Gamalinda AN, Arellano-Reyles A, Tupas GD, Derecho C, Ababon F, Edwardson J, Shilkofki NA. Effect of repeat refresher courses on neonatal resuscitation skill decay: an experimental comparative study of in-person and video-based simulation training. Adv Simul (Lond) 2023; 8:7. [PMID: 36841812 PMCID: PMC9959951 DOI: 10.1186/s41077-023-00244-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 02/03/2023] [Indexed: 02/27/2023] Open
Abstract
Neonatal deaths are a major contributor to global under-5-year-old mortality. Training birth attendants can improve perinatal outcomes, but skills may fade over time. In this pilot study, we assessed skill decay of nursing students after remote video versus in-person resuscitation training in a low-resource setting. Filipino nursing students (n = 49) underwent traditional, in-person simulation-based Helping Babies Breathe (HBB) training in Mindanao, Philippines. Participants were then assigned to receive refresher training at 2-month intervals either in-person or via tele-simulation beginning at 2 months, 4 months, or 6 months after initial training. A knowledge examination and practical examination, also known as objective structured clinical examination B in the HBB curriculum, were administered before retraining to assess knowledge and skill retention at time of scheduled follow-up. Time to initiation of bag-mask ventilation (BMV) in seconds during simulated birth asphyxia was the primary outcome. Skill decay was evident at first follow-up, with average time to BMV increasing from 56.9 (range 15-87) s at initial post-training to 83.8 (range 32-128) s at 2 months and 90.2 (range 51-180) s at 4 months. At second follow-up of the 2-month group, students showed improved pre-training time to BMV (average 70.4; range 46-97 s). No statistical difference was observed between in-person and video-trained students in time to BMV. Because of COVID-19 restrictions, the 6-month follow-up was not completed. We conclude that remote video refresher training is a reasonable alternative to traditional in-person HBB training. Our study also suggests that refreshers may be needed more frequently than every 2 months to mitigate skill decay. Additional studies are necessary to assess the longitudinal impact of tele-simulation on clinical outcomes.
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Affiliation(s)
- Julia M McCaw
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Sarah E Gardner Yelton
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Sean A Tackett
- Department of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Rainier M L L Rapal
- Department of Pediatrics, Southern Philippines Medical Center, Davao City, Philippines
| | - Arianne N Gamalinda
- Operation Smile Philippines Foundation, Inc.-Mindanao Cleft Center, Davao City, Philippines
| | | | - Genevieve D Tupas
- Department of Pediatrics, College of Medicine, Davao Medical School Foundation Inc., Davao City, Philippines
| | - Ces Derecho
- Department of Obstetrics and Gynecology, College of Medicine, Davao Medical School Foundation, Inc., Davao City, Philippines
| | - Fides Ababon
- Department of Obstetrics and Gynecology, College of Medicine, Davao Medical School Foundation, Inc., Davao City, Philippines
| | - Jill Edwardson
- Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, MD, USA
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Peverini A, Lawson G, Petsas-Blodgett N, Oermann MH, Tola DH. Time-to-Task in Interval Simulated Cardiopulmonary Resuscitation Training: A Method for Maintaining Resuscitation Skills. J Perianesth Nurs 2022; 38:404-407. [PMID: 36585289 DOI: 10.1016/j.jopan.2022.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 08/09/2022] [Accepted: 08/10/2022] [Indexed: 12/30/2022]
Abstract
PURPOSE The literature supports interval simulation training as a means of improving nurses' cardiopulmonary resuscitation (CPR) skills. The aim of this project was to improve the time-to-task skills in single-rescuer basic life support (BLS) in an outpatient surgery center through interval simulation training. DESIGN Quality Improvement project. METHODS Twenty-nine nursing staff were included in this pretest/post-test within subjects interventional design quality improvement project. A 2-minute pretest cardiac arrest simulation was performed in the outpatient surgery center where time-to-task and quality of CPR data were collected. The pretest was followed by a lecture and CPR training. Three months later, the simulation was post-tested in an identical scenario with measures of time-to-task and quality of CPR. FINDINGS T4he mean times for code bell activation and initiation of CPR decreased significantly following the interval simulation training (P < .05). A clinically significant decrease was seen in the mean time-to-task placement of a backboard on code team arrival. CONCLUSION Interval simulation training is an effective means of maintaining CPR skills in the outpatient surgery center setting.
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Hilleren IHS, Christiansen B, Bjørk IT. Learning practical nursing skills in simulation centers - A narrative review. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2022; 4:100090. [PMID: 38745621 PMCID: PMC11080493 DOI: 10.1016/j.ijnsa.2022.100090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 07/08/2022] [Accepted: 07/20/2022] [Indexed: 10/17/2022] Open
Abstract
Background Practical skills are complex procedures integrating communication and caring, as well as technical and manual aspects. Simulation at a simulation/skills center offers a wide range of learning activities and aims to imitate patient situations. Objectives To investigate the international research literature on practical skills learning in simulation/skills centers in nursing education. Research questions: 1. What are the range and type of practical skills studied? 2. What learning activities are focused on in the studies included in the review? 3. What are the learning outcomes and how are they assessed? Design Narrative review. Methods We searched electronically and included studies from Medline Ovid, CINAHL, Eric, Embase, Academic Search Premiere, and Cochrane. Unique indexing terms and search strategies were developed for each database. The criteria for inclusion were bachelor nursing students as the study population and practical nursing skills learning in simulation/skills centers. We used Rayyan QCRIt for the initial screening and the Mixed Method Appraisal Tool for quality assessment. We used a narrative approach to synthesize the diverse range of studies. Findings One hundred and twenty-one studies from 26 countries published between January 2013 and March 2022 were included. The amount of quantitative research was overwhelming (n = 108). A total of 50 different practical skills were represented. The studies focused on which learning modalities resulted in the best learning outcomes. Only 8.5% (n = 7) of the included studies concerned students' learning processes. Skill performance (n = 101), knowledge (n = 57), confidence (n = 34), and satisfaction (n = 32) were the main learning outcomes measured. Discussion The quality assessment indicated that 10 of the studies achieved 100% on the mixed method appraisal tool criteria. In many of the studies with quasi-experimental and randomized controlled trial designs, the intervention group received some form of educational treatment while the control group received no treatment. The choice of no treatment for the control group in pedagogical research seems to disregard the inherent purpose and effect of teaching and learning. Conclusion Heterogeneity in the use of learning modalities and measuring instruments precludes the possibility of building on other research. Technical skills were the preferred choice of skill, while skills that involved a fair measure of communication and collaboration were only sparingly studied. Students' learning processes were barely touched on in the included studies. More focus should be placed on this area in further research, since the choice of learning modalities may affect the students' learning processes in significant ways.
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Affiliation(s)
- Inger Helen Sekse Hilleren
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Bjørg Christiansen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
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Jiang H, Zong L, Li F, Gao J, Zhu H, Shi D, Liu J. Initial implementation of the resuscitation quality improvement program in emergency department of a teaching hospital in China. PeerJ 2022; 10:e14345. [PMID: 36405021 PMCID: PMC9673765 DOI: 10.7717/peerj.14345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 10/16/2022] [Indexed: 11/16/2022] Open
Abstract
Background Cardiopulmonary resuscitation (CPR) skills may decay over time after conventional instructor-led BLS training. The Resuscitation Quality Improvement® (RQI®) program, unlike a conventional basic life support (BLS) course, is implemented through mastery learning and low-dose, high-frequency training strategies to improve CPR competence. We facilitated the RQI program to compare the performance of novices vs those with previous BLS training experience before RQI implementation and to obtain their confidence and attitude of the RQI program. Methods A single-center observational study was conducted from May 9, 2021 to June 25, 2021 in an emergency department of a tertiary hospital. The performance assessment data of both trainees with a previous training experience in conventional BLS course (BLS group) and the novice ones with no prior experience with any BLS training (Non-BLS group) was collected by RQI cart and other outcome variables were rated by online questionnaire. Outcome measurements included chest compression and ventilation in both adult-sized and infant-sized manikins. Results A total of 149 participants were enrolled. Among them, 103 participants were in BLS group and 46 participants in Non-BLS group. Post RQI training, all the trainees achieved a passing score of 75 or more, and obtained an improvement in CPR performance. The number of attempts to pass RQI for compression and ventilation practice was lower in the BLS group in both adult and infant training sessions (P < 0.05). Although the BLS group had a poor baseline, it had fewer trials and the same learning outcomes, and the BLS group had better self-confidence. Trainees were well adapted to the innovative training modality, and satisfaction among all of the participants was high. Only the respondents for non-instructor led training, the satisfaction was low in both groups (72.8% in BLS group vs 65.2% in No-BLS group, strongly agreed). Conclusion Among novices, RQI can provide excellent CPR core skills performance. But for those who had previous BLS training experience, it was able to enhance the efficiency of the skills training with less time consumption. Most trainees obtained good confidence and satisfaction with RQI program, which might be an option for the broad prevalence of BLS training in China.
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Tsuruda T, Hamahata T, Endo GJ, Tsuruda Y, Kaikita K. Bystander-witnessed cardiopulmonary resuscitation by nonfamily is associated with neurologically favorable survival after out-of-hospital cardiac arrest in Miyazaki City District. PLoS One 2022; 17:e0276574. [PMID: 36269785 PMCID: PMC9586377 DOI: 10.1371/journal.pone.0276574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 10/10/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Bystander intervention in cases of out-of-hospital cardiac arrest (OHCA) is a key factor in bridging the gap between the event and the arrival of emergency health services at the site. This study investigated the implementation rate of bystander cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) and 1-month survival after OHCA in Miyazaki prefecture and Miyazaki city district as well as compared them with those of eight prefectures in the Kyushu-Okinawa region in Japan. In addition, we analyzed prehospital factors associated with survival outcomes in Miyazaki city district. METHODS We used data from an annual report released by the Fire and Disaster Management Agency of Japan (n = 627,982) and the Utstein reporting database in Miyazaki city district (n = 1,686) from 2015 to 2019. RESULT Despite having the highest rate of bystander CPR (20.8%), the 1-month survival rate (15.7%) of witnessed OHCA cases of cardiac causes in Miyazaki city district was comparable with that in the eight prefectures between 2015 and 2019. However, rates of survival (10.7%) in Miyazaki prefecture were lower than those in other prefectures. In 1,686 patients with OHCA (74 ± 18 years old, 59% male) from the Utstein reporting database identical to the 5-year study period in Miyazaki city district, binary logistic regression analysis demonstrated that age of the recipient [odds ratio (OR) 0.979, 95% confidential interval (CI) 0.964-0.993, p = 0.004)], witness of the arrest event (OR 7.501, 95% CI 3.229-17.428, p < 0.001), AED implementation (OR 14.852, 95% CI 4.226-52.201, p < 0.001), and return of spontaneous circulation (ROSC) before transport (OR 31.070, 95% CI 16.585-58.208, p < 0.001) predicted the 1-month survival with favorable neurological outcomes. In addition, chest compression at a public place (p < 0.001) and by nonfamily members (p < 0.001) were associated with favorable outcomes (p = 0.015). CONCLUSIONS We found differences in 1-month survival rates after OHCA in the Kyushu-Okinawa region of Japan. Our results suggest that on-field ROSC with defibrillation performed by nonfamily bystanders who witnessed the event determines 1-month neurological outcomes after OHCA in Miyazaki city district. Continued education of citizens on CPR techniques and better access to AED devices may improve outcomes.
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Affiliation(s)
- Toshihiro Tsuruda
- Faculty of Medicine, Department of Hemo-Vascular Advanced Medicine, Cardiorenal Research Laboratory, University of Miyazaki, Miyazaki, Japan
- * E-mail:
| | | | - George J. Endo
- Faculty of Medicine, Endowed Department of Disaster/Emergency Medical Support, University of Miyazaki, Miyazaki, Japan
- Department of Emergency Medicine, Kobayashi City Hospital, Kobayashi, Japan
| | - Yuki Tsuruda
- Department of Clinical Pharmacy, Doshisha Women’s College of Liberal Arts, Kyotanabe, Japan
| | - Koichi Kaikita
- Faculty of Medicine, Division of Cardiovascular Medicine and Nephrology, Department of Internal Medicine, University of Miyazaki, Japan
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Intensive Care Unit Nurses' Perceptions and Experience Using the American Heart Association Resuscitation Quality Improvement Program. CLIN NURSE SPEC 2022. [DOI: 10.1097/nur.0000000000000673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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de Araujo NR, de Araújo RA, Moretti MA, Chagas ACP. Nursing training and retraining on cardiopulmonary resuscitation: a theoretical-practical intervention. Rev Esc Enferm USP 2022; 56:e20210521. [PMID: 35532957 PMCID: PMC10111395 DOI: 10.1590/1980-220x-reeusp-2021-0521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 02/17/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To analyze the retention of knowledge and skills of nursing professionals following training and retraining on cardiopulmonary resuscitation. METHOD This is an intervention, prospective, and analytical study in which 56 nursing professionals received theoretical and practical training in in-service cardiopulmonary resuscitation. Nine months after the first training (T1), these professionals participated in a retraining (T2). They were followed up for 18 months. The linear trend of knowledge and skills in the period following training was calculated and the Wilcoxon test was applied. RESULTS Interventions increased the knowledge and skills of professionals significantly; however, in the subsequent period, skills decreased. Despite this, after a period of nine months, they were still higher than those identified before the study. There was a reduction of 18.2% in knowledge in the theoretical test after T1 vs 13.0% after T2 (p < 0.01) and a reduction of 7.6% in skills on the practical test after T1 vs 5.3% after T2 (p < 0.01). CONCLUSION Nurses were able to retain more knowledge and skills on cardiopulmonary resuscitation after retraining, which stresses the importance of regular training and continuing education in health.
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Affiliation(s)
- Nyagra Ribeiro de Araujo
- Centro Universitário FMABC, Faculdade de Medicina do ABC, Programa de Pós-Graduação em Ciências da Saúde, Santo André, SP, Brazil
| | - Raul Amaral de Araújo
- Universidade Federal de Pernambuco, Departamento de Prótese e Cirugia Bucofacial, Recife, PE, Brazil
| | - Miguel Antonio Moretti
- Centro Universitário FMABC, Faculdade de Medicina do ABC, Departamento de Cardiologia, Santo André, SP, Brazil
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Hu Y, Zheng B, Zhu L, Tang S, Lu Q, Song Q, Zhang N, Zhong Y. The effectiveness of emergency knowledge training of pediatric medical workers based on the knowledge, skills, simulation model: a quasi-experimental study. BMC MEDICAL EDUCATION 2022; 22:213. [PMID: 35351112 PMCID: PMC8966279 DOI: 10.1186/s12909-022-03267-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 03/16/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Basic life support and advanced life support are essential emergency management skills for medical workers, and pediatricians' first aid skills can be improved through emergency knowledge training. METHODS A controlled pre-post-intervention quasi-experimental study design was used. The study setting was a tertiary children's hospital in China. In November 2019, a KSS model of emergency knowledge learning was developed and tested, and pediatric medical workers (N = 1448) were trained with it. The outcome measures were based on an emergency knowledge questionnaire devised by the authors that measured the effectiveness of training by comparing the pre-and post-training scores of the particpants. RESULTS Pediatric medical workers scored significantly higher in total emergency knowledge after the training course than before [75.00 (62.50, 85.00) versus 100.00 (95.00, 100.00); P = 0.00]. Basic life support and advanced life support knowledge score significantly improved after training. Teamwork scores were significantly higher after the training than before [5.00 (5.00, 10.00) versus 10.00 (10.00, 10.00); P = 0.00]. Scores were significantly higher after the training (P < 0.001), especially for case analysis questions (P = 0.00). The attitudes of the medical workers towards the training were all positive and affirmative. CONCLUSION The KSS model was shown to be effective in improving the emergency knowledge of pediatric medical workers. Future research will be to explore the effectiveness of the model with different participants and at other hospitals or other institutions such as schools, encouraging more people to participate in and evaluate the model to promote its optimization. TRIAL REGISTRATION Hunan Children's Hospital, HCHLL-2018-03.
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Affiliation(s)
- Yaojia Hu
- Nursing Department, Hunan Children's Hospital, Changsha, China
| | - Bingya Zheng
- The School of Pediatrics, Hengyang Medical School, University of South China Hunan Children's Hospital, Changsha, China
| | - Lihui Zhu
- Nursing Department, Hunan Children's Hospital, Changsha, China
| | - Shuo Tang
- Medical Department Emergency Office, Hunan Children's Hospital, Changsha, China
| | - Qi Lu
- Medical Department Emergency Office, Hunan Children's Hospital, Changsha, China
| | - Qingqing Song
- Department of Cardiology, Hunan Children's Hospital, Changsha, China
| | - Na Zhang
- School of Nursing, Hunan University of Chinese Medicine, Changsha, China
| | - Yan Zhong
- Child Health Care Center, Hunan Children's Hospital, Changsha, China.
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Oermann MH, Krusmark MA, Kardong-Edgren S, Jastrzembski TS, Gluck KA. Personalized Training Schedules for Retention and Sustainment of Cardiopulmonary Resuscitation Skills. Simul Healthc 2022; 17:e59-e67. [PMID: 34009911 PMCID: PMC8812420 DOI: 10.1097/sih.0000000000000559] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The study examined how the spacing of training during initial acquisition of cardiopulmonary resuscitation (CPR) skill affects longer-term retention and sustainment of these skills. METHODS This was a multiphased, longitudinal study. Nursing students were randomly assigned to 2 initial acquisition conditions in which they completed 4 consecutive CPR training sessions spaced by shorter (1 or 7 days) or longer (30 or 90 days) training intervals. Students were additionally randomized to refresh skills for 1 year every 3 months, 6 months, or at a personalized interval prescribed by the Predictive Performance Optimizer (PPO), a cognitive tool that predicts learning and decay over time. RESULTS At the end of the acquisition period, performance was better if training intervals were shorter. At 3 or 6 months after acquisition, performance was better if initial training intervals were longer. At 1 year after acquisition, compression and ventilation scores did not differ by initial training interval nor by 3-month or PPO-prescribed sustainment interval refreshers. However, 6-month interval refreshers were worse than the PPO for compressions and worse than 3 months for ventilations. At the final test session, participants in the personalized PPO condition had less variability in compression scores than either the 3- or 6-month groups. CONCLUSIONS Results suggest that CPR learning trajectories may be accelerated by first spacing training sessions by days and then expanding to longer intervals. Personalized scheduling may improve performance, minimize performance variability, and reduce overall training time.
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A novel retraining strategy of chest compression skills for infant CPR results in high skill retention for longer. Eur J Pediatr 2022; 181:4101-4109. [PMID: 36114832 PMCID: PMC9483516 DOI: 10.1007/s00431-022-04625-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 09/02/2022] [Accepted: 09/13/2022] [Indexed: 11/17/2022]
Abstract
Infant cardiopulmonary resuscitation (iCPR) is often poorly performed, predominantly because of ineffective learning, poor retention and decay of skills over time. The aim of this study was to investigate whether an individualized, competence-based approach to simulated iCPR retraining could result in high skill retention of infant chest compressions (iCC) at follow-up. An observational study with 118 healthcare students was conducted over 12 months from November 2019. Participants completed pediatric resuscitation training and a 2-min assessment on an infant mannequin. Participants returned for monthly assessment until iCC competence was achieved. Competence was determined by passing assessments in two consecutive months. After achieving competence, participants returned just at follow-up. For each 'FAIL' during assessment, up to six minutes of practice using real-time feedback was completed and the participant returned the following month. This continued until two consecutive monthly 'PASSES' were achieved, following which, the participant was deemed competent and returned just at follow-up. Primary outcome was retention of competence at follow-up. Descriptive statistics were used to analyze demographic data. Independent t-test or Mann-Whitney U test were used to analyze the baseline characteristics of those who dropped out compared to those remaining in the study. Differences between groups retaining competence at follow-up were determined using the Fisher exact test. On completion of training, 32 of 118 participants passed the assessment. Of those achieving iCC competence at month 1, 96% retained competence at 9-10 months; of those achieving competence at month 2, 86% demonstrated competence at 8-9 months; of those participants achieving competence at month 3, 67% retained competence at 7-8 months; for those achieving competence at month 4, 80% demonstrated retention at 6-7 months. Conclusion: Becoming iCC competent after initial training results in high levels of skill retention at follow-up, regardless of how long it takes to achieve competence. What is Known: • Infant cardiopulmonary resuscitation (iCPR) is often poorly performed and skills decay within months after training. • Regular iCPR skills updates are important, but the optimal retraining interval considering individual training needs has yet to be established. What is New: • Infant chest compression (iCC) competence can be achieved within one to four months after training and once achieved, it can be retained for many months. • With skill reinforcement of up to 28 minutes after initial training, 90% of individuals were able to achieve competence in iCC and 86% retained this competence at follow-up.
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Gravesteijn BY, Schluep M, Lingsma HF, Stolker RJ, Endeman H, Hoeks SE. Between-centre differences in care for in-hospital cardiac arrest: a prospective cohort study. Crit Care 2021; 25:329. [PMID: 34507601 PMCID: PMC8431928 DOI: 10.1186/s13054-021-03754-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 08/04/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Survival after in-hospital cardiac arrest is poor, but current literature shows substantial heterogeneity in reported survival rates. This study aims to evaluate care for patients suffering in-hospital cardiac arrest (IHCA) in the Netherlands by assessing between-hospital heterogeneity in outcomes and to explain this heterogeneity stemming from differences in case-mix or differences in quality of care. METHODS A prospective multicentre study was conducted comprising 14 centres. All IHCA patients were included. The adjusted variation in structure and process indicators of quality of care and outcomes (in-hospital mortality and cerebral performance category [CPC] scale) was assessed with mixed effects regression with centre as random intercept. Variation was quantified using the median odds ratio (MOR), representing the expected odds ratio for poor outcome between two randomly picked centres. RESULTS After excluding centres with less than 10 inclusions (2 centres), 701 patients were included of whom, 218 (32%) survived to hospital discharge. The unadjusted and case-mix adjusted MOR for mortality was 1.19 and 1.05, respectively. The unadjusted and adjusted MOR for CPC score was 1.24 and 1.19, respectively. In hospitals where personnel received cardiopulmonary resuscitation (CPR) training twice per year, 183 (64.7%) versus 290 (71.4%) patients died or were in a vegetative state, and 59 (20.8%) versus 68 (16.7%) patients showed full recovery (p < 0.001). CONCLUSION In the Netherlands, survival after IHCA is relatively high and between-centre differences in outcomes are small. The existing differences in survival are mainly attributable to differences in case-mix. Variation in neurological outcome is less attributable to case-mix.
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Affiliation(s)
- B Y Gravesteijn
- Department of Public Health, Erasmus University Medical Center, Postbus, 3000 CA, Rotterdam, The Netherlands.
- Department of Anesthesiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
| | - M Schluep
- Department of Anesthesiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - H F Lingsma
- Department of Public Health, Erasmus University Medical Center, Postbus, 3000 CA, Rotterdam, The Netherlands
| | - R J Stolker
- Department of Anesthesiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - H Endeman
- Department of Intensive Care, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - S E Hoeks
- Department of Anesthesiology, Erasmus University Medical Center, Rotterdam, The Netherlands
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Tanaka M, Tezuka S. A scoping review of alternative methods of delivering ethics education in nursing. Nurs Open 2021; 9:2572-2585. [PMID: 34255926 PMCID: PMC9584469 DOI: 10.1002/nop2.987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 04/22/2021] [Accepted: 06/08/2021] [Indexed: 11/08/2022] Open
Abstract
AIM We conducted a scoping review of nursing ethics education to examine educational formats that go beyond traditional lectures. DESIGN This study was a scoping review. METHODS We used seven databases and relevant search terms, including nursing ethics, morals, values, nursing students and nursing ethics education. RESULTS Of 5,190 papers, 14 quasi-experimental studies met the inclusion criteria. All papers examined practices and self-study added to traditional lecture styles (i.e. the control group). Five practices emerged as follows: combined web (i.e. Internet) and lecture, web-based self-study, simulation, group learning and analysing ethical issues. The purpose, method and evaluation method differed based on the country in which the study was conducted. These educational interventions yielded significant differences in knowledge and in nursing students' critical thinking and ethical sensitivity postintervention. Multi-faceted ethics education will lay the foundation for effective practical training and practice.
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Affiliation(s)
- Maki Tanaka
- Nagano College of Nursing, Komagane, Japan.,St. Luke's International University, Chuo-ku, Japan
| | - Sonoe Tezuka
- St. Luke's International University, Chuo-ku, Japan
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Berg I, Haveman B, Markovic O, van de Schoot D, Dikken J, Goettinger M, Peden AE. Characteristics of surfers as bystander rescuers in Europe. Am J Emerg Med 2021; 49:209-215. [PMID: 34144263 DOI: 10.1016/j.ajem.2021.06.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 05/26/2021] [Accepted: 06/04/2021] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Coastal locations contribute significantly to global drowning, with surfers frequently conducting rescues. This study explored the characteristics of surfers as bystander rescuers in Europe. METHODS A cross-sectional online survey collected demographics (age, sex, geographical location), surfing experience, ability, lifesaving and cardiopulmonary resuscitation (CPR) training, information seeking behaviors and previous performance of a rescue. Analyses comprised descriptive frequencies, binomial logistic regression with adjusted odds ratio (AOR) (95% confidence interval [CI]) and chi-squares (p < .05). RESULTS Europe-dwelling respondents totaled 1705 (76% male; 43% 25-34 years). Thirty-nine percent (39.2%; n = 668) had previously performed a rescue. Likelihood of having conducted a rescue significantly increased with 6 or more years of surfing experience (6-10 years [AOR = 1.96; 95%CI: 1.20-3.22]; 11-15 years [AOR = 3.26; 95%CI: 1.56-6.79]; 16 years or more [AOR = 4.27; 95%CI: 2.00-9.11]) when compared to surfers with <1 year experience. Expert/professional ability surfers were 10.89 times (95%CI: 4.72-25.15) more likely to have conducted a rescue than novice/beginners. Respondents who had received both a certified lifeguard and CPR course were significantly more likely to have conducted a rescue (AOR = 3.34; 95%CI: 2.43-4.60). CONCLUSION Surfers who had previously conducted rescues commonly had more years of experience, higher self-rated surf ability and greater likelihood of having received certified training. However, not all surfers who have performed rescues had received training. Findings suggest surfers should receive rescue and CPR training before they start surfing at locations without trained supervision and refresh training regularly. Surfers are amenable to injury prevention information, especially online and via apps.
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Affiliation(s)
- Ingvar Berg
- Surfing Medicine International, the Netherlands; Emergency Medicine Department, Haaglanden Medical Centre, The Hague, The Netherlands
| | | | | | | | - Jeroen Dikken
- Faculty of Health, Nutrition and Sport & Health Innovation Centre of Expertise, The Hague University of Applied Sciences, The Hague, the Netherlands
| | | | - Amy E Peden
- School of Population Health, Faculty of Medicine and Health, UNSW Sydney, Kensington, New South Wales, Australia.
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Iglesias NJ, Williams TP, Snyder CL, Sommerhalder C, Perez A. Value Analysis of Central Line Simulation-Based Education. Am Surg 2021; 88:2678-2685. [PMID: 33877936 DOI: 10.1177/00031348211011134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Central line-associated bloodstream infections (CLABSIs) are preventable complications that pose a significant health risk to patients and place a financial burden on hospitals. Central line simulation-based education (SBE) efforts vary widely in the literature. The aim of this study was to perform a value analysis of published central line SBE and develop a refined method of studying central line SBE. METHODS A database search of PubMed Central and Cumulative Index to Nursing and Allied Health Literature (CINAHL) was performed for articles mentioning "Cost and CLABSI," "Cost and Central line Associated Bloodstream Infections," and "Cost and Central Line" in their abstract and article body. Articles chosen for qualitative synthesis mentioned "simulation" in their abstract and article body and were analyzed based on the following criteria: infection rate before vs. after SBE, cost of simulation, SBE design including simulator model used, and learner analysis. RESULTS Of 215 articles identified, 23 were analyzed, 10 (43.48%) discussed cost of central line simulation with varying criteria for cost reporting, 8 (34.8%) numerically discussed central line complication rates (7 CLABSIs and 1 pneumothorax), and only 3 (13%) discussed both (Figure). Only 1 addressed the true cost of simulation (including space rental, equipment startup costs, and faculty salary) and its longitudinal effect on CLABSIs. CONCLUSION Current literature on central line SBE efforts lacks value propositions. Due to the lack of value-based data in the area of central line SBE, the authors propose a cost reporting standard for use by future studies reporting central line SBE costs.
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Affiliation(s)
| | | | | | | | - Alexander Perez
- Department of Surgery, University of Texas Medical Branch, TX, USA
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Lim WY, Ong J, Ong S, Teo L, Fook-Chong S, Ho V. Rapid degradation of psychomotor memory causes poor quality chest compressions in frequent cardiopulmonary resuscitation providers and feedback devices can only help to a limited degree: A crossover simulation study. Medicine (Baltimore) 2021; 100:e23927. [PMID: 33663043 PMCID: PMC7909212 DOI: 10.1097/md.0000000000023927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 11/27/2020] [Indexed: 01/05/2023] Open
Abstract
Studies report a decline in the psychomotor memory of cardiopulmonary resuscitation (CPR) providers within months of training, but they are prone to subject bias. We hypothesized that this degradation is faster and more prevalent in real world practice. The aims of our study were to 1. assess the quality of chest compressions (CC) delivered routinely by CPR-certified clinicians who are not primed by study conditions, and 2. investigate if psychomotor memory degrades if feedback devices are removed. Forty anaesthetists and intensivists participated in a voluntary, half-day, randomized crossover study using case-based simulation. Participants were paired and randomly assigned into 2 groups; each receiving automated feedback either in the first or second cycle of CPR. Two cycles of CC and defibrillation (ACLS protocol) were administered on a manikin. CC parameters including overall quality were measured by a feedback device. The median proportion of good quality CC was poor at baseline but improved with feedback; 38.2% (IQR 27.7, 58.7) to 57.7% (IQR 38.0, 68.7), P < .05. The median proportion of good quality CC fell after feedback withdrawal; 50.5% (IQR 24.5, 67.7) to 25.6% (9, 37.6), P < .05. No carryover effect was observed. Treatment effect and period effect were detected. Baseline quality of CC amongst frequent CPR providers is poor, and can be improved partly by feedback devices. As psychomotor memory of good quality CCs degrades rapidly after removal of feedback, a multimodal approach is required for CPR skill retention. Future research on the optimal frequency of CPR training, including the use of feedback devices in clinical practice should be explored.
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Affiliation(s)
- Wan Yen Lim
- Division of Anaesthesiology and Perioperative Sciences, Outram Road, Singapore General Hospital
- Department of Anesthesiology, Sengkang General Hospital
| | - John Ong
- Department of Medicine, National University of Singapore
| | - Sharon Ong
- Department of Anesthesiology, Sengkang General Hospital
- Division of Anaesthesiology and Perioperative Sciences, Outram Road, Singapore General Hospital, Singapore; Duke-NUS Medical School
| | - L.M. Teo
- Department of Anesthesiology, Sengkang General Hospital
- Division of Anaesthesiology and Perioperative Sciences, Outram Road, Singapore General Hospital, Singapore; Duke-NUS Medical School
| | - S. Fook-Chong
- Health Services Research Unit, Singapore General Hospital
| | - V.K. Ho
- Department of Anesthesiology, Sengkang General Hospital
- Division of Anaesthesiology and Perioperative Sciences and Intensive Care, Outram Road, Singapore General Hospital, Singapore; Duke-NUS Medical School, Singapore
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