The effect of simulation-based flipped classroom on acquisition of cardiopulmonary resuscitation skills: A simulation-based randomized trial.

BACKGROUND: Cardiopulmonary resuscitation (CPR) is an essential skill required by critical care nurses. Evidence has shown that the use of a novel method called simulation-based flipped classroom (SBFC) can save training time in nursing laboratories and, to some extent, enhance social distancing during the current COVID-19 pandemic. AIM: To evaluate the effects of SBFC on nursing students' acquisition of CPR skills. STUDY DESIGN: A two-parallel prospective, single-centre, simulation-based, randomized, controlled trial. METHODS: The total sample size was 326 students. A CPR video was recorded and uploaded on Microsoft Teams channel for the SBFC group only. Thereafter, both groups demonstrated and redemonstrated the CPR procedure. Both groups were then compared according to the simulation experience satisfaction scale and CPR skills acquisition checklist. RESULTS: Two equally randomly selected groups of 163 undergraduate nursing students completed the study. The SBFC group had a significantly better satisfaction with the simulation experience than the traditional simulation (TS) group (p = 0.03). As regards the mean score of the CPR checklist after simulation, the SBFC group had a significantly higher score than TS group (p = 0.01). CONCLUSIONS: SBFC using a pre-recorded video can be an effective method that can reduce the time needed for CPR clinical simulation and can be used for the CPR simulation among critical care nurses. RELEVANCE TO CLINICAL PRACTICE: This study provides critical care nursing educators with a deep understanding regarding the benefits and value of utilizing the SBFC method in the clinical training of CPR skills. SBFC can be used to increase critical care nurses' satisfaction and skill acquisition during CPR training.

Association of position change and back massage and early ambulation with post-transfemoral coronary angiography complications.

INTRODUCTION: Transfemoral coronary angiography (TFCA) may be associated with postoperative complications, such as oozing, bleeding, ecchymosis, hematoma, and back pain. Thus, nursing practice must help enhance patient safety post-TFCA. OBJECTIVE: This study aimed to assess the association of position change and back massage (PCBM) and early ambulation (EA) with the development of post-TFCA complications. METHODS: This study adopted a randomized controlled trial design and was conducted at the coronary care unit of a university hospital in Egypt. A sample of 185 patients undergoing TFCA was evaluated during the first 6 h post-TFCA and randomly assigned to either the PCBM (n = 92) or EA (n = 93) group, with the latter receiving the intervention after the first 3 h post-TFCA. The patients were assessed using the Post-transfemoral Coronary Angiography Complication assessment tool. RESULTS: Comparing the two groups based on post-TFCA complications, the PCBM group had a lower frequency of bleeding, ecchymosis, hematoma and severe lower back pain whereas the EA group had a lower frequency of oozing, all of which were statistically significant (P < 0.05). CONCLUSION: PCBM post-TFCA can lower the frequency of significant vascular complications. RECOMMENDATION: Adopting PCBM may be valuable in post-TFCA nursing practice.

Relationship between ventilator bundle compliance and the occurrence of ventilator-associated events: a prospective cohort study.

BACKGROUND: Instead of ventilator-associated pneumonia (VAP), the modern definition of ventilator-associated events (VAEs) has been introduced to identify infectious and noninfectious respiratory complications. Some studies revealed that compliance to the ventilator bundle is associated with decreased occurrence of VAP, but little is known about its association with the decrease of VAEs occurrence. METHODS: A prospective cohort research design was used. Data were collected over eight months from May 2019 to February 2020 in five general intensive care units. The researchers assessed the compliance to ventilator care bundle using the Institute for Healthcare Improvement ventilation bundle checklist. Mechanically ventilated patients were prospectively assessed for the occurrence of VAEs using a pre-validated calculator from the Centers for Disease Control and Prevention. All are non-invasive tools and no intervention was done by the authors. RESULTS: A total of 141 mechanically ventilated patients completed the study. The odds ratio of having VAEs in patients who received ventilator bundle was -1.19 (95% CI, -2.01 to -0.38), a statistically significant effect, Wald χ2(1) = 8.18, p = 0.004. CONCLUSION/ IMPLICATIONS FOR PRACTICE: Ventilator bundle compliance was associated with a reduced risk for VAEs occurrence. Nurses should comply with the ventilator bundle because it is associated with decreased VAEs occurrence.