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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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Effect of a hybrid team-based advanced cardiopulmonary life support simulation program for clinical nurses. PLoS One 2022; 17:e0278512. [PMID: 36525410 PMCID: PMC9757587 DOI: 10.1371/journal.pone.0278512] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 11/17/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND During in-hospital cardiac arrest events, clinical nurses are often the first responders; therefore, nurses require sufficient advanced cardiac life support (ACLS) competency. This study aimed to verify the effects of a hybrid team-based ACLS simulation (HTAS) program (developed in this study) on nurses' ACLS performance, specifically ACLS knowledge, cardiopulmonary resuscitation (CPR) self-efficacy, and CPR-related stress. METHODS The developed HTAS comprised four lecture videos, one team-based skills training video, and a team-based ACLS simulation. A quasi-experimental pretest-posttest design with a comparison group (CG) was used to evaluate the effectiveness of the HTAS. Of the 226 general ward nurses with more than 6 months of clinical experience, 117 were allocated to the intervention group (IG), which attended the HTAS, and 109 to the CG, which attended only basic ACLS training. RESULTS The IG's ACLS performance significantly improved (t = 50.8, p < 0.001) after the training. Relative to the respective pretest conditions, posttest ACLS knowledge (t = 6.92, p < 0.001) and CPR self-efficacy (t = 6.97, p < 0.001) of the IG also significantly increased. However, when the mean difference values were compared, there was no significant difference between the two groups with respect to ACLS knowledge (t = 1.52, p = 0.130), CPR self-efficacy (t = -0.42, p = 0.673), and CPR stress (t = -0.88, p = 0.378). CONCLUSION The HTAS for ward nurses was effective at enhancing the nurses' ACLS performance. It is necessary to develop effective training methods for team-based ACLS and verify the sustained effects of such training.
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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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Sand K, Guldal AU, Myklebust TÅ, Hoff DAL, Juvkam PC, Hole T. Cardiopulmonary resuscitation retention training for hospital nurses by a self-learner skill station or the traditional instructor led course: A randomised controlled trial. Resusc Plus 2021; 7:100157. [PMID: 34467255 PMCID: PMC8384897 DOI: 10.1016/j.resplu.2021.100157] [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: 05/05/2021] [Revised: 08/01/2021] [Accepted: 08/01/2021] [Indexed: 10/26/2022] Open
Abstract
Introduction Intrahospital cardiac arrest has a steep mortality and high-quality cardiopulmonary resuscitation (CPR) is essential for favourable outcome. Instructor led (IL) CPR training is resource demanding and instructor free, feedback providing CPR skill stations (SS) could provide a means to enable the needed frequent retraining. The main objective of this study was to test the hypothesis that there was no difference between IL and SS training. Methods A total of 129 hospital nurses were randomised to CPR retraining in three groups; skill station with retraining at 2 months (SS-R), skill station without retraining (SS) and instructor led training (IL). Participants were tested at baseline, 2 and 8 months. The skill station groups were combined (c-SS) for analysis at baseline and 2 months when comparing to IL. Results Baseline characteristics for the three groups differed significantly, however c-SS and IL groups performed equally at baseline and testing at 2 months. At 8 months the SS group performed 71% correct ventilations compared to 54% in the IL group (p = 0.04), but CPR quality was otherwise equal. Longitudinal analysis showed SS-R performed 3.4 mm deeper compressions at final evaluation compared to baseline (p = 0.02) and 2.8 mm deeper compared to 2-month test (p = 0.02). No effects of retraining at 2 months could be detected at final comparison of SS-R and SS groups. Conclusion CPR training using a skill station led to equal performance at 2 and 8 months compared to instructor led training. Feedback-providing skill stations could be a feasible tool for required frequent retraining.
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Affiliation(s)
- Kristoffer Sand
- Department of Medicine, Ålesund Hospital, Møre & Romsdal Hospital Trust, Ålesund, Norway.,Department of Health Sciences in Ålesund, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Ålesund, Norway.,Department of Research and Innovation, Møre & Romsdal Hospital Trust, Ålesund, Norway
| | | | - Tor Åge Myklebust
- Department of Research and Innovation, Møre & Romsdal Hospital Trust, Ålesund, Norway
| | - Dag Arne Lihaug Hoff
- Department of Medicine, Ålesund Hospital, Møre & Romsdal Hospital Trust, Ålesund, Norway.,Department of Health Sciences in Ålesund, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Ålesund, Norway.,Department of Research and Innovation, Møre & Romsdal Hospital Trust, Ålesund, Norway
| | - Per Christian Juvkam
- Clinic of Emergency Medicine and Prehospital Care, St. Olav's University Hospital, Trondheim, Norway
| | - Torstein Hole
- Department of Medicine, Ålesund Hospital, Møre & Romsdal Hospital Trust, Ålesund, Norway.,Department of Health Sciences in Ålesund, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Ålesund, Norway
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Arrogante O, Ríos-Díaz J, Carrión-García L, Samith S, González-Romero GM, Caperos JM. Deliberate practice in resuscitation training using a feedback device, and the effects of the physical characteristics of the rescuer on the acquisition and retention of cardiopulmonary resuscitation skills: Randomized clinical trial. Int Emerg Nurs 2021; 58:101037. [PMID: 34332453 DOI: 10.1016/j.ienj.2021.101037] [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: 01/04/2021] [Revised: 04/28/2021] [Accepted: 05/31/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Cardiopulmonary resuscitation (CPR) skills decline rapidly and rescuers' physical characteristics could impact on their performance. Our aim was to analyse the effects of deliberate practice using a feedback device (FD) on the CPR performance of nursing students prior to, immediately after, and three months after training, considering their physical characteristics. METHOD Sixty nursing students participated in this randomized clinical trial (control group n = 28; training group n = 32). Their physical characteristics (weight, height, forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC)% index, handgrip strength, and CPR position strength) were measured before starting the trial. The training group followed a CPR training programme based on deliberate practice, providing feedback on their performance using an FD. All participants were evaluated during two-minute CPR compression/ventilation cycles. RESULTS The training group showed an improved ability to perform chest compressions (F(2, 115.2) = 13.3; p < .001; ω2p = 0.17) and ventilations (F(2, 115.3) = 102.1; p < .001; ω2p = 0.63), improving their overall quality of CPR (F(2, 115.2) = 40.1; p < .001; ω2p = 0.40). The physical characteristics of the participants did not affect CPR performance in any study phase. CONCLUSIONS A structured training programme based on deliberate practice using an FD had a positive effect on the acquisition of CPR skills by participants, while their physical characteristics had no impact on performance.
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Affiliation(s)
- Oscar Arrogante
- Fundación San Juan de Dios, Centro de Ciencias de la Salud San Rafael, Universidad de Nebrija, Paseo de La Habana, 70, 28036 Madrid, Spain.
| | - José Ríos-Díaz
- Fundación San Juan de Dios, Centro de Ciencias de la Salud San Rafael, Universidad de Nebrija, Paseo de La Habana, 70, 28036 Madrid, Spain.
| | - Laura Carrión-García
- Fundación San Juan de Dios, Centro de Ciencias de la Salud San Rafael, Universidad de Nebrija, Paseo de La Habana, 70, 28036 Madrid, Spain.
| | - Sabrina Samith
- Fundación San Juan de Dios, Centro de Ciencias de la Salud San Rafael, Universidad de Nebrija, Paseo de La Habana, 70, 28036 Madrid, Spain.
| | - Gracia María González-Romero
- Fundación San Juan de Dios, Centro de Ciencias de la Salud San Rafael, Universidad de Nebrija, Paseo de La Habana, 70, 28036 Madrid, Spain.
| | - José Manuel Caperos
- Fundación San Juan de Dios, Centro de Ciencias de la Salud San Rafael, Universidad de Nebrija, Paseo de La Habana, 70, 28036 Madrid, Spain; UNINPSI, Dpto. de Psicología, Universidad Pontificia Comillas, Madrid, Spain.
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Castillo Garcia J, Arbonés Arqué D, Belmonte Vico R, Rodriguez Higueras E. [Retention in the first few months after a basic life support skills course]. Aten Primaria 2021; 53:101973. [PMID: 33647637 PMCID: PMC7920801 DOI: 10.1016/j.aprim.2021.101973] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 12/02/2020] [Indexed: 11/24/2022] Open
Affiliation(s)
- Jordi Castillo Garcia
- Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España; Facultad de Medicina y Ciencias de la Salud, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, España.
| | - Daniel Arbonés Arqué
- Facultad de Medicina y Ciencias de la Salud, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, España; Unidad Coronaria, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España
| | - Ricardo Belmonte Vico
- Facultad de Medicina y Ciencias de la Salud, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, España; Unidad Cuidados Intensivos Cardiológicos, Hospital Universitari Vall d'Hebron, Barcelona, España
| | - Encarnación Rodriguez Higueras
- Facultad de Medicina y Ciencias de la Salud, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, España
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Knipe GA, Fox SD, Donatello RA. Deliberate Practice in Simulation: Evaluation of Repetitive Code Training on Nursing Students’ BLS Team Skills. Clin Simul Nurs 2020. [DOI: 10.1016/j.ecns.2020.08.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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8
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Cooper S, Cant R, Chung C. The Impact of Emerging Simulation-Based Technologies on the Management of Deteriorating Patients: Aiming for a Gold Standard Educational Evaluation. Clin Simul Nurs 2020. [DOI: 10.1016/j.ecns.2020.05.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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9
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Guetterman TC, Kellenberg JE, Krein SL, Harrod M, Lehrich JL, Iwashyna TJ, Kronick SL, Girotra S, Chan PS, Nallamothu BK. Nursing roles for in-hospital cardiac arrest response: higher versus lower performing hospitals. BMJ Qual Saf 2019; 28:916-924. [PMID: 31420410 DOI: 10.1136/bmjqs-2019-009487] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 08/01/2019] [Accepted: 08/06/2019] [Indexed: 11/04/2022]
Abstract
BACKGROUND Good outcomes for in-hospital cardiac arrest (IHCA) depend on a skilled resuscitation team, prompt initiation of high-quality cardiopulmonary resuscitation and defibrillation, and organisational structures to support IHCA response. We examined the role of nurses in resuscitation, contrasting higher versus lower performing hospitals in IHCA survival. METHODS We conducted a descriptive qualitative study at nine hospitals in the American Heart Association's Get With The Guidelines-Resuscitation registry, purposefully sampling hospitals that varied in geography, academic status, and risk-standardised IHCA survival. We conducted 158 semistructured interviews with nurses, physicians, respiratory therapists, pharmacists, quality improvement staff, and administrators. Qualitative thematic text analysis followed by type-building text analysis identified distinct nursing roles in IHCA care and support for roles. RESULTS Nurses played three major roles in IHCA response: bedside first responder, resuscitation team member, and clinical or administrative leader. We found distinctions between higher and lower performing hospitals in support for nurses. Higher performing hospitals emphasised training and competency of nurses at all levels; provided organisational flexibility and responsiveness with nursing roles; and empowered nurses to operate at a higher scope of clinical practice (eg, bedside defibrillation). Higher performing hospitals promoted nurses as leaders-administrators supporting nurses in resuscitation care at the institution, resuscitation team leaders during resuscitation and clinical champions for resuscitation care. Lower performing hospitals had more restrictive nurse roles with less emphasis on systematically identifying improvement needs. CONCLUSION Hospitals that excelled in IHCA survival emphasised mentoring and empowering front-line nurses and ensured clinical competency and adequate nursing training for IHCA care. Though not proof of causation, nurses appear to be critical to effective IHCA response, and how to support their role to optimise outcomes warrants further investigation.
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Affiliation(s)
- Timothy C Guetterman
- Interdisciplinary Studies, Creighton University, Omaha, Nebraska, USA
- Family Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Sarah L Krein
- Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Emergency Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Molly Harrod
- Center for Clinical Management Research, VA Ann Arbor Health Care System, Ann Arbor, Michigan, USA
| | - Jessica L Lehrich
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA
| | - Theodore J Iwashyna
- Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Center for Clinical Management Research, VA Ann Arbor Health Care System, Ann Arbor, Michigan, USA
| | | | - Saket Girotra
- Internal Medicine, University of Iowa Roy J and Lucille A Carver College of Medicine, Iowa City, Iowa, USA
| | - Paul S Chan
- Internal Medicine, Saint Luke's Health System, Kansas City, Missouri, USA
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Cheng A, Nadkarni VM, Mancini MB, Hunt EA, Sinz EH, Merchant RM, Donoghue A, Duff JP, Eppich W, Auerbach M, Bigham BL, Blewer AL, Chan PS, Bhanji F. Resuscitation Education Science: Educational Strategies to Improve Outcomes From Cardiac Arrest: A Scientific Statement From the American Heart Association. Circulation 2019; 138:e82-e122. [PMID: 29930020 DOI: 10.1161/cir.0000000000000583] [Citation(s) in RCA: 189] [Impact Index Per Article: 37.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The formula for survival in resuscitation describes educational efficiency and local implementation as key determinants in survival after cardiac arrest. Current educational offerings in the form of standardized online and face-to-face courses are falling short, with providers demonstrating a decay of skills over time. This translates to suboptimal clinical care and poor survival outcomes from cardiac arrest. In many institutions, guidelines taught in courses are not thoughtfully implemented in the clinical environment. A current synthesis of the evidence supporting best educational and knowledge translation strategies in resuscitation is lacking. In this American Heart Association scientific statement, we provide a review of the literature describing key elements of educational efficiency and local implementation, including mastery learning and deliberate practice, spaced practice, contextual learning, feedback and debriefing, assessment, innovative educational strategies, faculty development, and knowledge translation and implementation. For each topic, we provide suggestions for improving provider performance that may ultimately optimize patient outcomes from cardiac arrest.
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11
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Au K, Lam D, Garg N, Chau A, Dzwonek A, Walker B, Tremblay L, Boet S, Bould MD. Improving skills retention after advanced structured resuscitation training: A systematic review of randomized controlled trials. Resuscitation 2019; 138:284-296. [PMID: 30928503 DOI: 10.1016/j.resuscitation.2019.03.031] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 03/10/2019] [Accepted: 03/15/2019] [Indexed: 11/17/2022]
Abstract
AIMS To systematically evaluate the literature on interventions that improve skills retention following advanced structured resuscitation training programs designed for healthcare professionals. METHODS A systematic review of MEDLINE, EMBASE, CENTRAL, CINAHL, PsycINFO, ERIC, and Scopus was performed. Only randomized controlled trials investigating skills retention following advanced structured resuscitation training programs for healthcare professionals between inception to November 21, 2018 were included. Publications that assessed only knowledge acquisition were excluded. Relevant data from included studies were extracted and study quality was critically appraised, both independently and in duplicate by multiple reviewers. The risk of bias was assessed with the Cochrane Risk of Bias tool and the Medical Education Research Study Quality Instrument (MERSQI). Due to significant clinical heterogeneity in SRT training, study designs and interventions, a qualitative synthesis was used to summarize findings. MAIN RESULTS Sixteen studies, with a combined total of 1192 participants, were included in the final analysis. The majority of studies were conducted in North America and involved trainees or novice learners. ACLS was the most extensively studied, followed by NRP, ALS, and ATLS. Skills retention at 6 months was the most commonly used primary endpoint assessed using a simulated resuscitation checklist with either an adopted or created assessment tool. Most studies demonstrated a positive impact on skills retention when an interactive intervention or simulation was used. However, merely having a high-fidelity mannequin alone for simulation was found to have minimal effect on skills retention in the absence of other changes in content delivery. Booster sessions were found to be minimally effective in reinforcing long-term skills retention; however, most studies examining this intervention had small sample sizes and were underpowered. CONCLUSIONS Simulation-based interventions, refresher courses and adjustments to the content delivery of advanced structured resuscitation training courses were found to have the greatest impact on skills retention. However, due to significant heterogeneity and methodological flaws in the available studies, no definitive conclusions can be made regarding other interventions. Overall, there is a paucity of skills retention research and further high-quality randomized controlled trials are needed to determine the optimal intervention and design for resuscitation training that would maximize skills retention.
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Affiliation(s)
- Kelly Au
- Department of Anesthesiology, BC Women's Hospital, Vancouver, BC, Canada.
| | - Darren Lam
- Department of Anesthesiology Pharmacology and Therapeutics, University of British Columbia, Vancouver, BC, Canada
| | - Nitan Garg
- Department of Anesthesia, University of Toronto, Toronto, ON, Canada
| | - Anthony Chau
- Department of Anesthesiology, BC Women's Hospital, Vancouver, BC, Canada; Department of Anesthesiology Pharmacology and Therapeutics, University of British Columbia, Vancouver, BC, Canada
| | - Agata Dzwonek
- Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, Ottawa, ON, Canada
| | - Benjamin Walker
- Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Luc Tremblay
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - Sylvain Boet
- Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, Ottawa, ON, Canada
| | - M Dylan Bould
- Department of Anesthesia, University of Toronto, Toronto, ON, Canada; Department of Anesthesiology, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
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12
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Riggs M, Franklin R, Saylany L. Associations between cardiopulmonary resuscitation (CPR) knowledge, self-efficacy, training history and willingness to perform CPR and CPR psychomotor skills: A systematic review. Resuscitation 2019; 138:259-272. [PMID: 30928504 DOI: 10.1016/j.resuscitation.2019.03.019] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 03/05/2019] [Accepted: 03/17/2019] [Indexed: 11/30/2022]
Abstract
AIM To determine whether training history (including number of times and duration since last training), knowledge, self-efficacy or willingness are associated with cardiopulmonary resuscitation (CPR) psychomotor skills. METHODS Eight databases were systematically searched from January 2005 to February 2018 for articles that involved adult layperson participants and explored an association between training history, knowledge, self-efficacy or willingness and CPR psychomotor skills or survival outcomes after real CPR attempts. RESULTS Thirty-four articles with a total of 35,421 participants were included. CPR training was found to improve psychomotor skills, compared to no training, and any previous training was associated with better skills, compared to no previous training, however only the use of a popular song promoted meaningful retention of a specifically targeted skill, compared to standard training methods. Skills deteriorated within 3 months, then plateaued from 3 to 6 months. Self-efficacy was weakly associated with skill level, however knowledge was not associated with skill level. No studies assessed the association between willingness and psychomotor skills. CONCLUSION All laypeople should attend an instructor-led CPR training session with real-time or delayed feedback to improve CPR skills. Training sessions should utilise combinations of validated skill-specific training strategies, preferably including popular songs and feedback to help ensure skills retention. Refresher training, which focusses on skills and self-confidence rather than knowledge, should be undertaken every 3-6 months, although this timeframe needs further validation. All future studies assessing CPR psychomotor skills should adhere to a standardised reporting outcome list (proposed in this paper) to ensure consistency and comparability of results.
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13
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Scarneo SE, DiStefano LJ, Stearns RL, Register-Mihalik JK, Denegar CR, Casa DJ. Emergency Action Planning in Secondary School Athletics: A Comprehensive Evaluation of Current Adoption of Best Practice Standards. J Athl Train 2019; 54:99-105. [PMID: 30676786 DOI: 10.4085/1062-6050-82-18] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Emergency action plans (EAPs) are policies that improve response times and ensure access to emergency equipment for the management of patients with acute injuries and medical conditions, yet the extent to which EAP standards are adopted and implemented is unknown. OBJECTIVE To describe the extent of EAP adoption and implementation in secondary school (SS) athletics with athletic trainer (AT) services in the United States. DESIGN Cross-sectional study. SETTING Web-based questionnaire. PATIENTS OR OTHER PARTICIPANTS A national sample of ATs (n = 9642) was invited to participate in a Web-based questionnaire. MAIN OUTCOME MEASURE(S) Twelve components of EAP minimum best practices were derived from the "National Athletic Trainers' Association (NATA) Position Statement: Emergency Planning in Athletics." Emergency action plan components were analyzed using descriptive statistics with 95% confidence intervals (CIs) around proportions. Contingency tables (2 × 2) were used to calculate odds ratios (with 95% CIs) to assess adoption of the components (dichotomized as yes or no), employment factors (eg, full time versus part time, employed by clinic/district), and access to emergency equipment. RESULTS The response rate for the questionnaire was 13.2% (n = 1273). A majority of ATs (89.1%) reported having an EAP; however, only 9.9% described implementing all 12 components cited in the NATA position statement. Athletic trainers stated that they created the EAP in 62.8% (95% CI = 60.1%, 65.4%) of schools with an EAP. Athletic trainers employed full time were at greater odds of adopting 9 or more components of the EAP compared with ATs employed part time (odds ratio = 2.42 [95% CI = 1.66, 3.53]). A total of 85.7% of ATs noted access to an automated external defibrillator. CONCLUSIONS Although a majority of SSs had EAPs, the EAPs were often incomplete and lacked the necessary components for full compliance with the NATA position statement. These findings demonstrate the need for efforts to promote the adoption and implementation of comprehensive EAPs in SS athletics.
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Affiliation(s)
- Samantha E Scarneo
- Korey Stringer Institute, University of Connecticut, Storrs.,Department of Kinesiology, University of Connecticut, Storrs
| | | | - Rebecca L Stearns
- Korey Stringer Institute, University of Connecticut, Storrs.,Department of Kinesiology, University of Connecticut, Storrs
| | | | - Craig R Denegar
- Department of Kinesiology, University of Connecticut, Storrs
| | - Douglas J Casa
- Korey Stringer Institute, University of Connecticut, Storrs.,Department of Kinesiology, University of Connecticut, Storrs
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Abstract
Introduction The purpose of our study was to determine if regular cardiopulmonary resuscitation (CPR) practise improved the quality of nurses' chest compressions in a rural hospital. Methods The study was a prospective interventional trial measuring the effectiveness of brief, monthly CPR practice for rural nurses. The quality of nurses' chest compressions was measured before and after monthly practise with an interactive feedback device at the Golden and District Hospital, a rural facility in BC. Results All three components of high-quality CPR (depth, recoil and rate) improved significantly. Conclusion Monthly practise of chest compressions with an interactive feedback device improved the quality and confidence of nurses' CPR skills. These results suggest that a higher frequency of CPR practice (than the minimum annual recertification) would improve both the quality and retention of CPR skills, specifically for low-volume rural hospitals.
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Affiliation(s)
- Zoe Evans
- Golden and District Hospital, Golden, BC, Canada
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15
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Kim EJ, Roh YS. Competence-based training needs assessment for basic life support instructors. Nurs Health Sci 2018; 21:198-205. [PMID: 30444071 DOI: 10.1111/nhs.12581] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 09/18/2018] [Accepted: 10/04/2018] [Indexed: 01/29/2023]
Abstract
Basic life support instructors play an important role in the planning, implementation, and evaluation of basic life support education. However, little is known about basic life support instructors' competence. The aim of the present study was to identify basic life support instructors' competence attributes and assess their competence-based training needs according to their expertise. This was a descriptive survey study to identify the educational needs of basic life support instructors using importance and performance analysis. A Web-based survey with a 29 item Competence Importance-Performance scale was undertaken with a convenience sample of 213 Korean instructors. Factor analysis identified several important factors for the competence of instructors: assessment, professional foundations, planning and preparation, educational method and strategies and evaluation. The importance and performance analysis matrix showed that training priorities for novice instructors were communication with learners and instructors, learner motivation, educational design, and qualifications of instructors, whereas checking equipment status and educational environment had the highest training priority for experienced instructors. Assessment was the most important factor in basic life support instructor's competence. A competence-based training program is needed according to basic life support instructors' expertise.
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Affiliation(s)
- Eun Jin Kim
- Department of Nursing, Hanyang University, Seoul, Korea
| | - Young Sook Roh
- Red Cross College of Nursing, Chung-Ang University, Seoul, Korea
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Abstract
New graduate nurses frequently identify mock codes as anxiety-provoking events for them. Mock codes practiced in a safe environment can help ease nurses' anxiety and build confidence. Although one academic medical center has provided mock code experiences for several years, the new graduate nurses requested more practice time. Recent evidence identified deliberate practice as an alternative way to practice skills repeatedly and efficiently. Deliberate practice for mock codes was implemented and has been evaluated positively.
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17
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Cantrell MA, Franklin A, Leighton K, Carlson A. The Evidence in Simulation-Based Learning Experiences in Nursing Education and Practice: An Umbrella Review. Clin Simul Nurs 2017. [DOI: 10.1016/j.ecns.2017.08.004] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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18
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Katch RK, Scarneo SE, Adams WM, Armstrong LE, Belval LN, Stamm JM, Casa DJ. Top 10 Research Questions Related to Preventing Sudden Death in Sport and Physical Activity. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2017; 88:251-268. [PMID: 28805553 DOI: 10.1080/02701367.2017.1342201] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Participation in organized sport and recreational activities presents an innate risk for serious morbidity and mortality. Although death during sport or physical activity has many causes, advancements in sports medicine and evidence-based standards of care have allowed clinicians to prevent, recognize, and treat potentially fatal injuries more effectively. With the continual progress of research and technology, current standards of care are evolving to enhance patient outcomes. In this article, we provided 10 key questions related to the leading causes and treatment of sudden death in sport and physical activity, where future research will support safer participation for athletes and recreational enthusiasts. The current evidence indicates that most deaths can be avoided when proper strategies are in place to prevent occurrence or provide optimal care.
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Jung J, Shilkofski N. Pediatric Resuscitation Education in Low-Middle-Income Countries: Effective Strategies for Successful Program Development. J Pediatr Intensive Care 2016; 6:12-18. [PMID: 31073421 DOI: 10.1055/s-0036-1584673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 02/15/2016] [Indexed: 01/09/2023] Open
Abstract
Despite established international guidelines, there is considerable variability in the quality of resuscitative care received by critically ill children in low-middle-income countries. While this problem is certainly multifactorial, education of health care workers is an important determinant of care quality. This article will discuss approaches to health care worker education in pediatric resuscitation in low-middle-income countries, with emphasis on aspects of educational programs that may contribute to positive educational and clinical outcomes.
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Affiliation(s)
- Julianna Jung
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Nicole Shilkofski
- Department of Anesthesiology/Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States.,Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
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20
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Saramma PP, Raj LS, Dash PK, Sarma PS. Assessment of long-term impact of formal certified cardiopulmonary resuscitation training program among nurses. Indian J Crit Care Med 2016; 20:226-32. [PMID: 27303137 PMCID: PMC4906335 DOI: 10.4103/0972-5229.180043] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
CONTEXT Cardiopulmonary resuscitation (CPR) and emergency cardiovascular care guidelines are periodically renewed and published by the American Heart Association. Formal training programs are conducted based on these guidelines. Despite widespread training CPR is often poorly performed. Hospital educators spend a significant amount of time and money in training health professionals and maintaining basic life support (BLS) and advanced cardiac life support (ACLS) skills among them. However, very little data are available in the literature highlighting the long-term impact of these training. AIMS To evaluate the impact of formal certified CPR training program on the knowledge and skill of CPR among nurses, to identify self-reported outcomes of attempted CPR and training needs of nurses. SETTING AND DESIGN Tertiary care hospital, Prospective, repeated-measures design. SUBJECTS AND METHODS A series of certified BLS and ACLS training programs were conducted during 2010 and 2011. Written and practical performance tests were done. Final testing was undertaken 3-4 years after training. The sample included all available, willing CPR certified nurses and experience matched CPR noncertified nurses. STATISTICAL ANALYSIS USED SPSS for Windows version 21.0. RESULTS The majority of the 206 nurses (93 CPR certified and 113 noncertified) were females. There was a statistically significant increase in mean knowledge level and overall performance before and after the formal certified CPR training program (P = 0.000). However, the mean knowledge scores were equivalent among the CPR certified and noncertified nurses, although the certified nurses scored a higher mean score (P = 0.140). CONCLUSIONS Formal certified CPR training program increases CPR knowledge and skill. However, significant long-term effects could not be found. There is a need for regular and periodic recertification.
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Affiliation(s)
- P P Saramma
- Division of Nursing Education, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| | - L Suja Raj
- Division of Nursing Service, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| | - P K Dash
- Department of Anaesthesiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| | - P S Sarma
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
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