How the gender of a victim character in a virtual scenario created to learn CPR protocol affects student nurses' performance.

BACKGROUND AND OBJECTIVE: Virtual simulations recreate scenarios where student nurses can practice procedures in a safe and supervised manner and with no risk to the patient. Virtual scenarios include digital characters that reproduce human actions. Generally, these characters are modeled as males and restricted roles are assigned to females. Our objective is to evaluate how the character gender of a victim in a scenario created to practice the cardiopulmonary resuscitation protocol (CPR) affects performance of student nurses. METHODS: Three virtual scenarios with cardiac arrest victims modeled as males or females were assigned to 41 students of the Nursing Faculty to practice the CPR protocol. We evaluated student performance with respect to the time to remove clothes, the time to perform the CPR maneuver, and the hands position for CPR. Chi-square, Fisher exact, and Mann-Whitney U were used to test primary outcome measures in the experimental design of victim character sex (male vs. female) and student sex (men vs. women). RESULTS: The analysis performed did not find statistically differences in time to remove clothes or in time to start CPR. With respect to hands placement we also did not find significant difference in any of the cases. CONCLUSION: Nurse student actions are not influenced by the character gender of the victim. Excellent results with respect to hands placement to start CPR are obtained. Virtual scenarios can be a suitable strategy to reduce gender differences in gender sensitive situations such as CPR performance.

Proyecto Girona Territori Cardioprotegit: evaluación del funcionamiento de los desfibriladores públicos / The Girona Territori Cardioprotegit project: performance evaluation of public defibrillators

Introducción y objetivos: La desfibrilación pública ha potenciado la difusión y el uso de los desfibriladores externos automáticos (DEA) de manera exponencial, pero se carece de datos recientes sobre su uso en nuestro medio. Se realizó un análisis descriptivo del funcionamiento de los DEA desde el despliegue de un programa de desfibrilación pública. Métodos: Análisis retrospectivo de los trazados electrocardiográficos registrados y del funcionamiento de los desfibriladores, en el marco de un programa de desfibrilación pública en la provincia de Girona, desde su inicio en junio de 2011 hasta junio de 2015. Resultados: De 231 activaciones, se dispuso de información completa en 188, entre dispositivos móviles (82%) y fijos (18%). La asistolia fue el ritmo más prevalente (42%), mientras que un 23% de los ritmos fueron fibrilación ventricular. La especificidad de los dispositivos identificando ritmos desfibrilables fue del 100%, pero hubo 8 falsos negativos (sensibilidad del 83%). En el caso de los 47 ritmos desfibrilables, la tasa de recuperación de la circulación espontánea fue del 49% (23 casos). No hubo ningún accidente relacionado con el uso del dispositivo. Conclusiones: Casi la mitad de los ritmos registrados fueron asistolias. Los DEA analizados presentaron excelentes seguridad y especificidad, con una sensibilidad moderada. El DEA trató con éxito a la mitad de los pacientes que presentaron ritmo desfibrilable (AU)

Introduction and objectives: In recent years, public access defibrillation programs have exponentially increased the availability of automatic external defibrillators (AED) in public spaces but there are no data on their performance in our setting. We conducted a descriptive analysis of the performance of AED since the launch of a public defibrillation program in our region. Methods: A retrospective analysis was conducted of electrocardiographic tracings and the performance of AED in a public defibrillation program from June 2011 to June 2015 in the province of Girona, Spain. Results: There were 231 AED activations. Full information was available on 188 activations, of which 82% corresponded to mobile devices and 18% to permanent devices. Asystole was the most prevalent rhythm (42%), while ventricular fibrillation accounted for 23%. The specificity of the device in identifying a shockable rhythm was 100%, but there were 8 false negatives (sensitivity 83%). There were 47 shockable rhythms, with a spontaneous circulation recovery rate of 49% (23 cases). There were no accidents related to the use of the device (AU)

The Girona Territori Cardioprotegit Project: Performance Evaluation of Public Defibrillators.

INTRODUCTION AND OBJECTIVES: In recent years, public access defibrillation programs have exponentially increased the availability of automatic external defibrillators (AED) in public spaces but there are no data on their performance in our setting. We conducted a descriptive analysis of the performance of AED since the launch of a public defibrillation program in our region. METHODS: A retrospective analysis was conducted of electrocardiographic tracings and the performance of AED in a public defibrillation program from June 2011 to June 2015 in the province of Girona, Spain. RESULTS: There were 231 AED activations. Full information was available on 188 activations, of which 82% corresponded to mobile devices and 18% to permanent devices. Asystole was the most prevalent rhythm (42%), while ventricular fibrillation accounted for 23%. The specificity of the device in identifying a shockable rhythm was 100%, but there were 8 false negatives (sensitivity 83%). There were 47 shockable rhythms, with a spontaneous circulation recovery rate of 49% (23 cases). There were no accidents related to the use of the device. CONCLUSIONS: Nearly half of the recorded rhythms were asystole. The AED analyzed showed excellent safety and specificity, with moderate sensitivity. Half the patients with a shockable rhythm were successfully treated by the AED.

Using a serious game to complement CPR instruction in a nurse faculty.

Cardiopulmonary resuscitation (CPR) is a first aid key survival technique used to stimulate breathing and keep blood flowing to the heart. Its effective administration can significantly increase the chances of survival for victims of cardiac arrest. LISSA is a serious game designed to complement CPR teaching and also to refresh CPR skills in an enjoyable way. The game presents an emergency situation in a 3D virtual environment and the player has to save the victim applying the CPR actions. In this paper, we describe LISSA and its evaluation in a population composed of 109 nursing undergraduate students enrolled in the Nursing degree of our university. To evaluate LISSA we performed a randomized controlled trial that compares the classical teaching methodology, composed of self-directed learning for theory plus laboratory sessions with a mannequin for practice, with the one that uses LISSA after self-directed learning for theory and before laboratory sessions with a mannequin. From our evaluation we observed that students using LISSA (Group 2 and 3) gave significantly better learning acquisition scores than those following traditional classes (Group 1). To evaluate the differences between students of these groups we performed a paired samples t-test between Group 1 and 2 (µ1=35, 67, µ2=47, 50 and p<0.05) and between students of Group 1 and 3 (µ1=35, 67, µ3=50, 58 and p<0.05). From these tests we observed that there are significant differences in both cases. We also evaluated student performance of main steps of CPR protocol. Students that use LISSA performed better than the ones that did not use it.