["Arrhythmia Reading": A Diverse Teaching Approach to Improve the Ability of 2 Year NPGY Nurses to Interpret and Manage Arrhythmias].

BACKGROUND: The author of this paper works in the critical care ward of an internal medicine department. During the study period, current trainees in a nurse post graduate year (NPGY) program joined our nurse team. While at our ward, they were required to demonstrate clinical nursing competencies in intensive care units in the facets of nursing knowledge, equipment use, prediction of emergencies, emergency response, and patient evaluation and management. The ability to interpret arrhythmias is critical to connecting and coordinating these competencies. However, arrhythmia interpretation is usually the most difficult skill for nurses to master. PURPOSE: This study was developed to improve the knowledge of NPGY trainees regarding arrhythmia interpretation, the accuracy of their arrhythmia interpretation and management, and their confidence in caring for patients with arrhythmia. RESOLUTION: The period of this study spanned from April 5th to June 18th, 2018. After surveying the current capabilities of the NPGY trainees to provide a reference for improvement, several teaching strategies were adopted. These strategies included: (1) provision of arrhythmia clinical scenarios; (2) establishment of multimedia teaching and interactive e-books; (3) development of memory strategies; and (4) mind mapping. RESULTS: The accuracy of the trainees' knowledge regarding arrhythmia interpretation increased from 52.5% pretest to 92.5% posttest, while their arrhythmia interpretation skill improved from 56.3% pretest to 92.5% posttest. Furthermore, their caring-for-patients-with-arrhythmia confidence score increased from 5.5 to 9.1. All of the objectives of this study were achieved. CONCLUSIONS: The diverse teaching approach employed in this study enhanced the ability of trainees to remember and recall relevant theories as well as improved their related practical skills. Furthermore, posttest, the trainees were significantly less nervous during encounters with patients with arrhythmia and demonstrated improved problem-solving abilities. Participation in this intervention significantly improved the confidence of trainees to serve as critical care nurses and to pursue a career in critical care nursing.

[A nursing case experience using Levine's conservation model to provide sepsis care].

Sepsis is a systemic inflammation caused by severe infection. It is a condition that is life-threatening, progresses rapidly, and affects multiple system functions. An evidence-based medical sepsis bundles model has been used for sepsis care in clinic practice. Therefore, a holistic nursing care protocol for patients with sepsis is needed to improve medical outcomes. This case study describes a nursing experience using Levine's Conservation Model to care for a patient with sepsis. Data were collected using physical assessment, medical chart reviews, written communications with the patient, interviews patient family members, and observing the patient during intensive care hospitalization from June 10th, 2011 through July 5th, 2011. Levin's Conservation Model, used as the nursing guideline, successfully identified patient issues including failure to conserve energy, structural, personal and social integrity. Interventions included: (1) sepsis bundles and early goal directed therapy to reduce patient energy expenditure; (2) prevention of infection to maintain structural function; and (3) enhancement of self-esteem, privacy, family cohesion, and social activities to maintaining personal and social integrity functions. The interventions helped the case adapt successfully to the sepsis-related imbalance. This case report provides a valuable nursing care experience as a reference for similar sepsis cases in the future.