Peripheral Intravenous Catheter Insertion: Professionals' Performance and Implications for Patient Safety: A Cross-Sectional Study.

This study evaluated peripheral intravenous catheter insertion by licensed practical nurses in a simulated scenario. This cross-sectional and descriptive study was performed in a general hospital's simulation center located in Brazil, from January to October 2020. The authors developed a tool from the leading guidelines to measure peripheral intravenous catheter insertion performance in 60 licensed practical nurses. Data were analyzed using descriptive statistics, with proportions for categorical variables and analytical statistics to denote significance, using SPSS version 22.0. Ethical aspects were respected. Despite the sample comprising professionals who declared an average experience with peripheral intravenous catheter insertion of 6.4 years, at least 50% failed in some tool element. This low score on peripheral intravenous catheter insertion performance is because automation is possible without efforts to improve it. Adding years of practice does not generate better performance. The licensed practical nurses' performance was lower than expected, considering their reported experience, which poses a risk to patient safety. The training of these professionals needs to be discussed in countries where the practice is legal. Skills training should include simulation to approximate clinical practice; nurses must exercise their role in supervising the team.

Effect of rapid cycle deliberate practice in peripheral intravenous catheters insertion training: A simulation experimental study.

AIM: to compare the effect of rapid cycle deliberate practice simulation training with skill-training simulation on peripheral intravenous catheter insertion for Licensed Practical Nurses. BACKGROUND: The use of peripheral intravenous catheters is associated with high rates of complications, although it is widely used in clinical practice. Training strategies to ensure good performance can minimize the risks inherent to this procedure. DESIGN: A randomized simulation experimental pre-post interventional study. METHODS: Sixty participants were allocated to intervention (n = 30) or control (n = 30) groups. Participants allocated to the intervention group were trained through the Rapid cycle deliberate practice simulation strategy, while participants in the control group were trained through the skill-training simulation strategy. A pre-test was applied before any intervention and a post-test after intervention. The primary outcome was the performance in the peripheral intravenous catheter insertion skill. The comparison of correct performance in the tests was analyzed intergroup and intragroup. The effect size of the interventions was also analyzed. The t-Student and Mann-Whitney tests compared the difference between the groups. The training effect was calculated by Cohen's dm and Glass's Δ measures. RESULTS: Performance between the pre-post-test increased from 59.4% to 96% (p < 0.001) in the intervention group and from 57.8% to 93.5% in the control group (p < 0001). There was no statistical difference between the groups after intervention (p = 0225). Cohen's dm measurement was 2.95 and 3.59 in the control and intervention groups, respectively. CONCLUSIONS: The rapid cycle deliberate practice simulation strategy resulted in Licensed Practical Nurses' performance improvements in peripheral intravenous catheter insertion, evidenced by the increase of correct performance actions in the post-test compared to the pre-test. However, with no statistical difference compared to the skill-training simulation strategy.

Can support surfaces characteristics influence high-quality chest compression? manikin experiment with a mechanical device.

BACKGROUND: Support surfaces variables, such as size, material, and density, can determine chest compression depth in cardiopulmonary resuscitation. OBJECTIVE: to analyze the force required to do a high-quality chest compression concerning different surfaces in CPR. METHOD: This experimental study was developed using a Little Anne manikin and a mechanical device to perform chest compressions. Nine sets of surfaces were tested and compared to a control. RESULTS: 230 experimental tests were done in sets of bed or stretcher + mattress and presence or absence of different backboards. In the control condition, the average force to reach 5 cm of depth was 42.14±0.97 (kgf). Set 9, compatible with a narrow stretcher with a thin mattress, had the best surfaces to reach recommended depth, with or without a backboard. All other sets required significantly more force for high-quality chest compression. Regression analysis confirms that backboard size is not significant for the force for high-quality chest compression. CONCLUSION: There is an association of dimensions and types of beds or stretchers and mattresses with a force increase. Type and dimensions of the backboard are not relevant for the force required, regardless of the characteristics of the set of the bed or stretcher and mattress.

Parada cardiorrespiratória na pandemia por coronavírus: revisão compreensiva da literatura / Cardiorespiratory arrest in a coronavirus pandemic: comprehensive literature review / Paro cardiorrespiratorio en una pandemia de coronavirus: revisión exhaustiva de la literatura

Objetivo: apresentar atualizações para a ressuscitação cardiopulmonar em pacientes suspeitos e confirmados com COVID-19. Método: revisão compreensiva da literatura, com síntese narrativa das evidências de diretrizes e recomendações da Organização Mundial de Saúde, Associação de Medicina Intensiva Brasileira, American Heart Association, Resuscitation Council UK, American College of Surgions Committee on Trauma e National Association of Emergency Medical Technicians. Resultados: as principais atualizações trazem informações sobre especificidades das manobras de ressuscitação cardiopulmonar; preparação do ambiente, recursos humanos e materiais, reconhecimento da parada cardiorrespiratória e ações iniciais; estratégias de ventilação e acesso invasivo da via aérea; ajustes do ventilador mecânico e manobras de ressuscitação cardiopulmonar em pacientes pronados. Considerações finais: profissionais de saúde envolvidos no atendimento à parada cardiorrespiratória de pacientes suspeitos e/ou confirmados com COVID-19 podem encontrar inúmeros desafios, portanto devem seguir com rigor o protocolo estabelecido para maximizar a efetividade das manobras de ressuscitação e minimizar o risco de contágio pelo vírus e sua disseminação.

Objective: to present updates for cardiopulmonary resuscitation in suspected and confirmed patients with COVID-19. Method: comprehensive literature review with narrative synthesis of the evidence of guidelines and recommendations from World Health Organization, Associação de Medicina Intensiva Brasileira, American Heart Association, Resuscitation Council UK, American College of Surgions Committee on Trauma and National Association of Emergency Medical Technicians. Results: the main updates bring information about the specifics of cardiopulmonary resuscitation maneuvers; preparation of the environment and human and material resources, recognition of cardiorespiratory arrest and initial actions; ventilation and invasive airway access strategies; mechanical ventilator adjustments and cardiopulmonary resuscitation maneuvers in patients in the prone position. Final considerations: health professionals involved in the care of cardiorespiratory arrest of suspected and/or confirmed patients with COVID-19 can face numerous challenges, so they must strictly follow the protocol established to maximize the effectiveness of resuscitation maneuvers and minimize the risk of contagion by the virus and its spread.

Objetivo: apresentar actualizaciones para la reanimación cardiopulmonar en pacientes sospechos os y confirmados con COVID-19. Método: revisión exhaustiva de la literatura con síntesis narrativa de la evidencia de guías y recomendaciones de la Organización Mundial de la Salud, Associação de Medicina Intensiva Brasileira, American Heart Association, Resuscitation Council UK, American College of Surgions Committee on Trauma and National Association of Emergency Medical Technicians. Resultados: las principales actualizaciones aportan información sobre los detalles de las maniobras de reanimación cardiopulmonar; preparación del medio ambiente y recursos humanos y materiales, reconocimiento de paro cardiorrespiratorio y acciones iniciales; estrategias de ventilación y acceso invasivo a las vías aéreas; ajustes del ventilador mecánico y maniobras de reanimación cardiopulmonar en pacientes en decúbito prono. Consideraciones finales: los profesionales de la salud involucrados en la atención del paro cardiorrespiratorio de pacientes sospechosos y/o confirmados con COVID-19 pueden enfrentar numerosos desafíos, por lo que deben seguir estrictamente el protocolo establecido para maximizar la efectividad de las maniobras de reanimación y minimizar el riesgo de contagio por el virus y supropagación.

Satisfação e autoconfiança de graduandos de enfermagem em práticas de habilidades e cenários simulados / Satisfaction and self-confidence of nursing students in skill practices and simulated scenarios

Introdução: A simulação é uma estratégia de aprendizado que tem sido cada vez mais aplicada na educação de enfermagem. O uso desta ferramenta gera a necessidade da utilização de instrumentos confiáveis e válidos para orientar as atividades desenvolvidas. Objetivo: Avaliar a satisfação e a autoconfiança no aprendizado dos estudantes de enfermagem submetidos a práticas de habilidades e cenários simulados. Metodologia: Pesquisa observacional com abordagem quantitativa em um Laboratório de Habilidades e Simulação de uma Universidade localizada no município do Rio de Janeiro. Realizada com graduandos de enfermagem (matriculados no 3º período e 6º período) a partir da aplicação da Escala de Satisfação e Autoconfiança com a Aprendizagem (ESAA), composta por 13 itens do tipo likert de 5 pontos, dividida em duas dimensões: Satisfação (05 itens) e Autoconfiança na aprendizagem (08 itens). Resultados: Foram incluídos 49 discentes. O participante da pesquisa é tipicamente do sexo feminino (89,8%), pardos e negros (57,1%), tem de 21 a 23 anos (55,1%) e sem experiência anterior com a simulação (93,9%). A partir da análise item a item percebeu-se a eficácia do método de ensino utilizado (98%) com impacto positivo para a forma como o professor ensinou (97,9%) alinhada com a forma que o aluno aprende (95,9), reforçando que a atuação do docente tem extrema relevância na satisfação. Conclusão: Este estudo atingiu os objetivos traçados e demonstrou que a simulação pode ser uma opção factível no aprendizado de estudantes de enfermagem para a prática clínica. Níveis elevados em ambas as dimensões foram encontradas, sendo os de satisfação mais significativos do que os de autoconfiança. A avaliação dessas dimensões pode não refletir diretamente resultados de aprendizagem, mas são essenciais para o aprimoramento da simulação como técnica de ensino pelas instituições e docentes.

Introduction: Simulation is a learning strategy that has been increasingly applied in nursing education. The use of this tool generates the need to use reliable and valid instruments to guide the activities developed. Objective: evaluate the satisfaction and self-confidence of nursing students during learning when they are submitted to praticed skills and simulated scenarios. Methodology: observational research with quantitative approach conducted on Skills and Simulation Laboratory of a University located in the city of Rio de Janeiro. Performed with nursing students (enrolled in the 3rd and 6th period) using the Student Satisfaction and Self-Confidence in Learning (SSSCL). The scale is similar a 5 points Likert Scale. It has 13 items and it is categorized in two dimensions: Satisfaction (05 items) and Self-confidence in learning (08 items). Results: 49 students were included. The research participant is typically female (89.8%), brown and black (57.1%), 21-23 years old (55.1%) and with no experience in simulation (93.9%). The analysis of each of the 13 points showed the effectiveness of the teaching method used (98%), with a positive impact on the way the teacher taught (97.9%) and was aligned with the way the student learns (95, 9), reinforcing that teacher performance is extremely relevant to satisfaction. Conclusion: this study achieved the goals and demonstrated that simulation can be a feasible option in nursing students learning for clinical practice. High levels in both dimensions were reach, being those of satisfaction more significant than those of self-confidence. The evaluation of these dimensions may not directly reflect learning results, but they are essential for the improvement of simulation as a teaching technique by institutions and teachers.