Conhecimento dos profissionais intra-hospitalares acerca do suporte básico de vida em uma parada cardiorrespiratória / In-hospital professionals' knowledge about basic life support in cardiac arrest / Conocimiento de los profesionales intrahospitalarios sobre el soporte vital básico en la parada cardíaca

Objetivo: avaliar o efeito da intervenção educativa no conhecimento da equipe de enfermagem sobre o suporte básico de vida para o atendimento à parada cardiorrespiratória de adultos no ambiente intra-hospitalar. Método: estudo transversal com abordagem quantitativa, realizado com 25 profissionais de enfermagem em dois hospitais de região oeste de Santa Catarina - Brasil. Avaliou-se por meio da aplicação de um pré-teste, intervenção educativa e pós-teste. Resultados: houve aumento significativo no conhecimento dos profissionais. O hospital A obteve a média de acertos de 7,23 no pré-teste, elevando para 11,33 no pós-teste, com valor de p ≤ 0,0001. Já o hospital B pontuou 6,07 no pré-teste, progredindo para 11,15 no pós-teste, valor de p ≤ 0,0006. Conclusão: a intervenção realizada demonstrou ser uma estratégia eficaz, visto que os resultados pré-teste demostravam déficit significativo de conhecimento, e após a intervenção educativa, mostraram melhoria na maioria dos itens avaliados em relação ao atendimento específico.

Objective: to evaluate the effect of an educational intervention on the nursing team's knowledge about basic life support for adult cardiac arrest care in the in-hospital environment. Method: cross-sectional study with a quantitative approach, carried out with 25 nursing professionals in two hospitals in the western region of Santa Catarina - Brazil. A pre-test, educational intervention and post-test were applied. Results: there was a significant increase in the professionals' knowledge. Hospital A had a mean score of 7.23 in the pre-test, increasing to 11.33 in the post-test, with p-value ≤ 0.0001. Hospital B scored 6.07 in the pre-test, increasing to 11.15 in the post-test, p-value ≤ 0.0006. Conclusion: the intervention proved to be an effective strategy, since the pre-test results showed significant knowledge deficit, and after the educational intervention, showed improvement in most of the items evaluated in relation to specific care.

Objetivos:evaluar el efecto de una intervención educativa en el conocimiento del equipo de enfermería sobre el soporte vital básico para la atención del paro cardíaco del adulto en el ambiente intrahospitalario. Método: estudio transversal con abordaje cuantitativo, realizado con 25 profesionales de enfermería en dos hospitales de la región oeste de Santa Catarina - Brasil. Se aplicó un pre-test, una intervención educativa y un post-test. Resultados: hubo un aumento significativo de los conocimientos de los profesionales. El Hospital A obtuvo una puntuación media de 7,23 en el pre-test, aumentando a 11,33 en el post-test, con valor p ≤ 0,0001. El Hospital B obtuvo una puntuación de 6,07 en el pre-test, aumentando a 11,15 en el post-test, con valor p ≤ 0,0006. Conclusión: una intervención realizada demostró ser una estrategia eficaz, visto que os resultados previos demostraron un déficit significativo de conhecimento, y después de una intervención educativa, mostraron una mejoría na maioria dos itens avaliados em relação ao atendimento específico.

Construção e validação de vídeo educativo para estudantes de enfermagem sobre a parada cardiorrespiratória obstétrica / Construcción y validación de un video educativo para estudiantes de enfermería sobre parada cardiorrespiratoria obstétrica / Construction and validation of an educational video for nursing students about obstetric cardiopulmonary arrest

RESUMO Objetivo construir, validar e avaliar vídeo educativo para estudantes de enfermagem sobre a parada cardiorrespiratória obstétrica. Método estudo metodológico, composto pela construção do vídeo, validação de conteúdo por 22 especialistas em parada cardiorrespiratória obstétrica e avaliação por 21 estudantes de graduação em enfermagem. Utilizou-se o Instrumento de Validação de Conteúdo Educacional em Saúde, para validação com os especialistas, e o questionário adaptado do Suitability Assessment of Materials, para avaliação dos estudantes. Na validação com juízes e com o público-alvo, foi considerado válido o item com concordância mínima de 80%, obtida a partir do Índice de Validação de Conteúdo e do Teste Binomial. Resultados o vídeo, com duração de 8 minutos e 53 segundos, contemplou as etapas da assistência de enfermagem na realização do suporte básico de vida à gestante acometida por parada cardiorrespiratória. Na validação de conteúdo, dos 18 itens avaliados, 16 tiveram concordância de 100%, um obteve 95% e o item restante obteve 81%. Na avaliação dos estudantes, dos 13 itens avaliados, 12 possuíram concordância de 100% e o item restante possuiu 95%. Conclusão e implicações para a prática o vídeo foi considerado válido pelos especialistas em parada cardiorrespiratória obstétrica e compreensível pelos estudantes de enfermagem, assim, trata-se de recurso educativo viável para contribuir com a formação da enfermagem.

RESUMEN Objetivo construir, validar y evaluar videos educativos para estudiantes de enfermería sobre parada cardiopulmonar obstétrica. Método estudio metodológico, consistente en la construcción del video, validación de contenido por 22 expertos en parada cardiorrespiratoria obstétrica y evaluación por 21 estudiantes de enfermería. Se utilizó el Instrumento de Validación de Contenidos Educativos en Salud, para la validación con los expertos, y el cuestionario adaptado del Suitability Assessment of Materials, para la evaluación de los estudiantes. En la validación con jueces y público objetivo, se consideró válido el ítem con una concordancia mínima del 80%, obtenido del Índice de Validación de Contenido y la Prueba Binomial. Resultados el video, de 8 minutos y 53 segundos, contempló los pasos del cuidado de enfermería en la realización de soporte vital básico a gestantes afectadas por paro cardíaco. En la validación de contenido, de los 18 ítems evaluados, 16 tuvieron un 100% de concordancia, uno tuvo un 95% y el restante un 81%. En la evaluación de los estudiantes, de los 13 ítems evaluados, 12 tuvieron un 100% de concordancia, y el ítem restante tuvo un 95%. Conclusión e implicaciones para la práctica el video fue considerado válido por especialistas en parada cardiopulmonar obstétrica y comprensible por estudiantes de enfermería, por lo que es un recurso educativo viable para contribuir a la formación en enfermería.

ABSTRACT Objective to construct, validate and assess educational video for nursing students about obstetric cardiopulmonary arrest. Method this is a methodological study consisting of video construction, content validation by 22 experts in obstetric cardiopulmonary arrest and assessment by 21 undergraduate nursing students. The Health Educational Content Validation Instrument was used for validation with experts, and a questionnaire adapted from the Suitability Assessment of Materials, for student assessment. In the validation with judges and the target audience, the item with a minimum agreement of 80% was considered valid, obtained from the Content Validation Index and the binomial test, was considered valid. Results video, lasting 8 minutes and 53 seconds, contemplated nursing care stages in carrying out basic life support to pregnant women affected by cardiac arrest. In content validation, of the 18 items assessed, 16 had 100% agreement, one had 95% and the remaining item had 81%. In students' assessment, of the 13 items assessed, 12 had 100% agreement, and the remaining item had 95%. Conclusion and implications for practice the video was considered valid by experts in obstetric cardiopulmonary arrest and understandable by nursing students, thus it is a viable educational resource to contribute to nursing education.

Cardiac Arrest Nurse Leadership (CANLEAD) trial: a simulation-based randomised controlled trial implementation of a new cardiac arrest role to facilitate cognitive offload for medical team leaders.

BACKGROUND: Medical team leaders in cardiac arrest teams are routinely subjected to disproportionately high levels of cognitive burden. This simulation-based study explored whether the introduction of a dedicated 'nursing team leader' is an effective way of cognitively offloading medical team leaders of cardiac arrest teams. It was hypothesised that reduced cognitive load may allow medical team leaders to focus on high-level tasks resulting in improved team performance. METHODS: This randomised controlled trial used a series of in situ simulations performed in two Australian emergency departments in 2018-2019. Teams balanced on experience were randomised to either control (traditional roles) or intervention (designated nursing team leader) groups. No crossover between groups occurred with each participant taking part in a single simulation. Debriefing data were collected for thematic analysis and quantitative evaluation of self-reported cognitive load and task efficiency was evaluated using the NASA Task Load Index (NTLX) and a 'task time checklist' which was developed for this trial. RESULTS: Twenty adult cardiac arrest simulations (120 participants) were evaluated. Intervention group medical team leaders had significantly lower NTLX scores (238.4, 95% CI 192.0 to 284.7) than those in control groups (306.3, 95% CI 254.9 to 357.6; p=0.02). Intervention group medical team leaders working alongside a designated nursing leader role had significantly lower cognitive loads than their control group counterparts (206.4 vs 270.5, p=0.02). Teams with a designated nurse leader role had improved time to defibrillator application (23.5 s vs 59 s, p=0.004), faster correction of ineffective compressions (7.5 s vs 14 s, p=0.04), improved compression fraction (91.3 vs 89.9, p=0.048), and shorter time to address reversible causes (107.1 s vs 209.5 s, p=0.002). CONCLUSION: Dedicated nursing team leadership in simulation based cardiac arrest teams resulted in cognitive offload for medical leaders and improved team performance.

Factors Affecting Attitudes Toward Defibrillator Use Among Clinical Nurses in South Korea: A Cross-Sectional Study.

INTRODUCTION: Nurses are often first responders to in-hospital cardiac arrests. However, many nurses do not perform defibrillation even when required. Nurses' attitudes toward defibrillator use are influenced by social and psychological context. This descriptive, cross-sectional study explored factors affecting attitudes toward defibrillator use among nurses in South Korea. METHODS: A total of 280 nurses with a minimum of 6 months' clinical experience were included. The data were acquired through a self-administered questionnaire. Regression analysis was used to determine factors significantly associated with attitudes toward defibrillator use. RESULTS: Only 13.6% of the participating nurses had experience with defibrillator use in a cardiopulmonary resuscitation situation, whereas 94.6% of the nurses had received training on defibrillator use. Attitudes toward defibrillator use accounted for 37% of variance in measures of self-confidence, image, and job fit. DISCUSSION: To improve clinical nurses' attitudes toward defibrillator use, improving their self-confidence, image, and job fit through ongoing assessment and retraining on defibrillation is required. In addition, relevant institutional support and systematic guidelines should be provided.

Reversible causes of cardiac arrest: Nursing competency acquisition and clinical simulation satisfaction in undergraduate nursing students.

BACKGROUND: It is essential to determine and treat the reversible causes of cardiac arrest, so emergency nurses must acquire the competencies needed for its adequate management. METHOD: 106 undergraduate nursing students participated in a cross-sectional study, using a mixed-method. Simulated scenarios recreated critically ill patients with diagnoses of potentially reversible causes of cardiac arrest in an emergency room. An internally validated questionnaire was used to analyse students' satisfaction and perceptions about clinical simulation sessions. Nursing competencies were assessed using a verification list. Data were analysed using the IBM SPSS Statistics version 24.0 (quantitative data) and ATLAS-ti version 8.0 (qualitative data) software. RESULTS: Nursing students expressed a high level of satisfaction (most of the scores obtained were higher than 90%) and positive perceptions about clinical simulation sessions. Most of the students (85.6%) acquired the necessary nursing competencies for adequate management of the reversible causes of cardiac arrest. CONCLUSION: Clinical simulation methodology is a useful tool for the learning process and acquisition of nursing competencies related to emergency situations management. This methodology prepares nursing students for their clinical placements and future careers in emergency care. Therefore, it is recommended to extend clinical simulation training to emergency qualified nursing staff and advanced practitioners.

Conhecimento de estudantes de enfermagem sobre parada cardiorrespiratória: estudo transversal / Conocimiento de los estudiantes de enfermería sobre parada cardiorrespiratoria: estudio transversal / Knowledge of nursing students on cardiorespiratory arrest: a cross-sectional study

Objetivo avaliar o conhecimento de estudantes de enfermagem sobre o atendimento ao paciente em parada cardiorrespiratória. Método estudo transversal com abordagem quantitativa, realizado com 136 acadêmicos do curso de enfermagem de uma instituição de ensino superior. Os dados foram coletados por meio de instrumento semiestruturado. A análise efetivou-se por meio da estatística descritiva e inferencial. Resultados os discentes que se autoavaliaram positivamente, mostraram um bom nível de conhecimento sobre a temática (r=0,29; p=0,001), assim como aqueles que haviam cursado a disciplina de primeiros socorros em períodos anteriores (p=0,012). As questões nas quais obtiveram erro foram aquelas a respeito das vias de administração da droga e suporte ventilatório em pacientes não intubados. Conclusão os discentes de enfermagem demonstraram um nível adequado de compreensão dos protocolos sobre o atendimento ao paciente em parada cardiorrespiratória e possuíam arcabouço teórico obtido na disciplina de primeiros socorros, bem como em cursos de aperfeiçoamento.

Objetivo evaluar el conocimiento de los estudiantes de enfermería sobre el cuidado de los pacientes en parada cardiorrespiratoria. Método estudio transversal con abordaje cuantitativo, realizado con 136 estudiantes de enfermería de una institución de educación superior. Los datos fueron recogidos por medio de un instrumento semiestructurado. El análisis se realizó a través de estadística descriptiva e inferencial. Resultados los estudiantes que se evaluaron positivamente mostraron un buen nivel de conocimiento sobre el tema (r=0,29; p=0,001), así como los que habían asistido al curso de primeros auxilios en períodos anteriores (p=0,012). Las preguntas en las que obtuvieron error fueron las relativas a las vías de administración del fármaco y soporte ventilatorio en pacientes no intubados. Conclusión los estudiantes de enfermería demostraron un adecuado nivel de comprensión de los protocolos sobre el cuidado de pacientes en parada cardiorrespiratoria y contaron con un marco teórico obtenido en la disciplina de primeros auxilios, así como en cursos de perfeccionamiento.

Objective to evaluate the knowledge of nursing students about the care of patients in cardiorespiratory arrest. Method cross-sectional study with quantitative approach, conducted with 136 nursing students from a higher education institution. Data were collected using a semi-structured instrument. The analysis was performed through descriptive and inferential statistics. Results the students who positively evaluated themselves showed a good level of knowledge about the theme (r=0.29; p=0.001), as well as those who had attended the first aid course in previous periods (p=0.012). The questions they made mistakes were those regarding the routes of administration of the drug and ventilatory support in non-intubated patients. Conclusion the nursing students demonstrated an adequate level of understanding of the protocols on the care of patients in cardiorespiratory arrest and had a theoretical framework obtained in the discipline of first aid, as well as in improvement courses

Simulation in cardiorespiratory arrest: assessment of satisfaction with the learning of nursing students / Simulación de parada cardiorrespiratoria: evaluación de la satisfacción con el aprendizaje de estudiantes de enfermería / Simulação em parada cardiorrespiratória: avaliação da satisfação com a aprendizagem de estudantes de enfermagem

ABSTRACT Objective: To evaluate the satisfaction and self-confidence of undergraduate nursing students' learning in a scenario of realistic clinical simulation with the theme of advanced cardiopulmonary arrest maneuvers. Method: Exploratory-descriptive study, with a quantitative approach. In order to evaluate the simulation activity developed undergraduate nursing students responded to the Student Satisfaction and Self-Confidence with Learning Scale. Results: 19 students participated in the study. Students' satisfaction and self-confidence with learning were identified, with an average of 4.17 ± 0.59 in the developed scenario. In the subscale of satisfaction with current learning and in the subscale of self-confidence with learning, 86.3% and 76.6% of students scored the items in a maximum way (4-5), respectively. Conclusion: Nursing students demonstrate satisfaction and self-confidence with learning from a realistic clinical simulation scenario on the theme of advanced cardiorespiratory arrest maneuvers.

RESUMEN Objetivo: Evaluar la satisfacción y la autoconfianza de estudiantes de enfermería con el aprendizaje en un escenario de simulación clínica realista y con la temática de maniobras avanzadas de parada cardiorrespiratoria. Método: Se trata de un estudio exploratorio y descriptivo, de enfoque cuantitativo. Para evaluar la actividad de simulación desarrollada, estudiantes del curso de graduación de enfermería respondieron a la Escala de Satisfacción de Estudiantes y Autoconfianza con el Aprendizaje. Resultados: Participaron diecinueve estudiantes. Se identificó la satisfacción y la autoconfianza de los estudiantes con el aprendizaje, con una media de 4,17 ± 0,59 en el escenario desarrollado. En la subescala de satisfacción con el aprendizaje actual y en la subescala de autoconfianza con el aprendizaje, el 86,3% y el 76,6% de los estudiantes, respectivamente, puntuaron los ítems al máximo (4-5). Conclusión: Los estudiantes de enfermería demostraron satisfacción y autoconfianza con el aprendizaje en el escenario de simulación clínica realista, en la temática de maniobras avanzadas de parada cardiorrespiratoria.

RESUMO Objetivo: Avaliar a satisfação e autoconfiança com a aprendizagem de estudantes de enfermagem em cenário de simulação clínica realística com a temática de manobras avançadas de parada cardiorrespiratória. Método: Estudo exploratório-descritivo, com abordagem quantitativa. Para avaliação da atividade de simulação desenvolvida, estudantes do curso de graduação em enfermagem responderam à Escala de Satisfação de Estudantes e Autoconfiança com a Aprendizagem. Resultados: Participaram 19 estudantes. Identificou-se satisfação e autoconfiança dos estudantes com a aprendizagem, com média de 4,17 ± 0,59 no cenário desenvolvido. Na subescala de satisfação com a aprendizagem atual e na subescala de autoconfiança com a aprendizagem, 86,3% e 76,6% dos estudantes pontuaram os itens de forma máxima (4-5), respectivamente. Conclusão: Estudantes de enfermagem demonstram satisfação e autoconfiança com a aprendizagem a partir de cenário de simulação clínica realística na temática de manobras avançadas de parada cardiorrespiratória.

The cold truth about postcardiac arrest targeted temperature management: 33°C vs. 36°C.

This article provides nurses with up-to-date evidence to empower them in contributing to the 33°C versus 36°C discussion in postcardiac arrest targeted temperature management (TTM). Presented in debate format, this article addresses the pros and cons of various target temperatures, examines the evidence around TTM, and applies it to clinical scenarios.

Efeitos da aplicação periódica da simulação in situ para educação permanente em ressuscitação cardiopulmonar no contexto da hemodiálise / Effects of the periodic application of in situ simulation for permanent education in cardiopul-monary resuscitation in the context of haemodialysis

INTRODUÇÃO: A parada cardiorrespiratória é um evento crítico para o paciente dialítico, que necessita de uma equipe de enfermagem na hemodiálise apta a realizar o procedimento de ressuscitação cardiopulmonar. Justifica-se nesse contexto a educação permanente em enfermagem, que por meio da simulação in situ, pode contribuir com a construção das competências em ressuscitação cardiopulmonar. OBJETIVO: Verificar se diferentes periodicidades de formação utilizando a simulação in situ, influenciam na construção de competências para a ressuscitação cardiopulmonar no ambiente da hemodiálise. MATERIAL E MÉTODO: Trata-se de um estudo experimental não randomizado, realizado com profissionais de enfermagem de uma unidade de diálise situada em um Hospital Universitário de grande porte da região sul do Brasil. Os participantes foram alocados em 3 grupos que receberam periodicidades diferentes de intervenção (2, 4, e 8 meses). RESULTADOS: Os resultados apontaram diferenças estatisticamente significativa na análise do conhecimento, no grupo de periodicidade de 4 meses. Na avaliação das habilidades, observou-se resultado significativo (p = 0,048) para o grupo de periodicidade de 4 meses, na técnica da compressão torácica. CONCLUSÃO: Com este estudo demonstramos que a simulação in situ promoveu a construção de competências no intervalo a cada 4 meses, corroborando com o fato de que a aprendizagem por meio da experimentação e a reflexão, e dentro do contexto profissional, podem contribuir com a educação permanente em saúde. Mais estudos no contexto da diálise são necessários para confirmar e generalizar os achados

INTRODUCTION: Cardiac arrest is a critical event for the dialysis patient who needs a nursing staff in haemodialysis able to perform cardiopulmonary resuscitation. In this context, permanent nursing education is justified, which, through in situ simulation, can contribute to the construction of skills in cardiopulmonary resuscitation. OBJECTIVE: To verify whether different training periods using in situ simulation, influence the construction of skills for cardiopulmonary resuscitation in the haemodialysis environment. MATERIAL AND METHOD: A non-randomized experimental study was carried out with nursing professionals from a dialysis unit located in a large University Hospital in the southern region of Brazil. Participants were allocated to 3 groups that received different intervals of intervention (2, 4, and 8 months). RESULTS: The results showed statistically significant differences in the analysis of knowledge, in the 4-month group. In assessing skills, a significant result (p = 0.048) was observed for the 4-month group, using the chest compression technique. CONCLUSION: This study shows that in situ simulation promotes the construction of skills in an interval of 4 months, corroborating that learning through experimentation and reflection, and within the professional context, can contribute to permanent education in health. More studies are needed in the context of dialysis to confirm and generalize the findings

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Maximum emergency department overcrowding is correlated with occurrence of unexpected cardiac arrest.

BACKGROUND: Emergency department overcrowding negatively impacts critically ill patients and could lead to the occurrence of cardiac arrest. However, the association between emergency department crowding and the occurrence of in-hospital cardiac arrest has not been thoroughly investigated. This study aimed to evaluate the correlation between emergency department occupancy rates and the incidence of in-hospital cardiac arrest. METHODS: A single-center, observational, registry-based cohort study was performed including all consecutive adult, non-traumatic in-hospital cardiac arrest patients between January 2014 and June 2017. We used emergency department occupancy rates as a crowding index at the time of presentation of cardiac arrest and at the time of maximum crowding, and the average crowding rate for the duration of emergency department stay for each patient. To calculate incidence rate, we divided the number of arrest cases for each emergency department occupancy period by accumulated time. The primary outcome is the association between the incidence of in-hospital cardiac arrest and emergency department occupancy rates. RESULTS: During the study period, 629 adult, non-traumatic cardiac arrest patients were enrolled in our registry. Among these, 187 patients experienced in-hospital cardiac arrest. Overall survival discharge rate was 24.6%, and 20.3% of patients showed favorable neurologic outcomes at discharge. Emergency department occupancy rates were positively correlated with in-hospital cardiac arrest occurrence. Moreover, maximum emergency department occupancy in the critical zone had the strongest positive correlation with in-hospital cardiac arrest occurrence (Spearman rank correlation ρ = 1.0, P < .01). Meanwhile, occupancy rates were not associated with the ED mortality. CONCLUSION: Maximum emergency department occupancy was strongly associated with in-hospital cardiac arrest occurrence. Adequate monitoring and managing the maximum occupancy rate would be important to reduce unexpected cardiac arrest.

Effect of providing basic life support for improving skills in first aid on cardiac arrest for student of senior high school in Kediri

Basic: Life support is an emergency measure to make the airway, breathing without obstruction and helps maintain blood circulation without using tools. Student nurses perform nursing profession must have the skills to perform basic life support basic life support. Help in improving basic life skills student nursing profession in the implementation of basic life support in RSU Karsa Husada Batu. The study design was quasi (quasi-experimental designs) to design one group pre test and post test. Data collection tools with observation sheet with a sample of 30 respondents using random sampling techniques. The independent variable in this study is the simulation simulated basic life support and the dependent variable in this study is the student skills in performing simulated basic life support. Data were analyzed using the Wilcoxon statistical test-signed rank test with α=0.05. RESULTS: showed before getting simulated basic life support skills of the respondents have enough skill as much as 46.7% (14 respondents) and after getting simulated basic life support skills of respondents, 76.73% (23 respondents). Based on Wilcoxon test signed rank test (Asym.p Sig. 2 tailed) earned value 0.000. Because the value of 0.000 is less than <0.05. It can be concluded that there effect simulation help in improving basic life skills nursing profession student assistance in implementing the basic life in RSU Karsa Husada Batu. Students of the nursing profession who have obtained basic aid simulation have good skills increases due to learning their simulations to the knowledge and practice in performing basic life support

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A comparative study of video lecture versus video lecture and high fidelity simulation for training nurses on the delivery of targeted temperature management after cardiac arrest.

INTRODUCTION: Targeted temperature management (TTM) is recommended for cardiac arrest patients. Successful implementation of a TTM protocol depends on the nurses' knowledge and skills. The study's aim was to compare the level of knowledge, psychomotor skills, confidence and satisfaction before, immediately after and at 6 weeks after training nurses on the delivery of TTM with video lecture versus video lecture and high fidelity simulation. METHOD: Demographic variables were compared across treatment groups using t-tests and Chi-square tests. Change over 6 weeks after intervention was tested with mixed effects model. RESULTS: Fifty-two registered nurses were enrolled. Knowledge test scores, the primary outcome, did not differ between the groups immediately after the training (beta = 3.80, SE = 3.47, p = .27), but there was a strong trend 6 weeks after the training in favor of simulation (beta = 7.93, SE = 3.88, p = .04). Skills were significantly better immediately after the training in the simulation group, but no different 6 weeks later. No difference in confidence was found at either post-test point. Simulation-trained nurses were more satisfied with their training at both post-testing points. CONCLUSION: In this study of training approaches to TTM after cardiac arrest, nurses trained with video lecture and high fidelity simulation benefitted from this approach by maintaining their TTM knowledge longer.

An Initiative Using Simulation to Aid in Retention of Advanced Cardiac Life Support Knowledge and Skills in an Emergency Department Nurse Residency Program.

INTRODUCTION: Cardiac arrest is the most urgent type of emergency, and favorable outcomes are best achieved by early resuscitation. Advanced Cardiac Life Support (ACLS) certification enables nurses to provide care to patients who are at a high risk of life-threatening emergencies. OBJECTIVE: The objective of this quality improvement project was to explore the retention of knowledge and skills of 20 graduate nurses who participated in a nurse residency program using an ACLS simulation-based learning experience (SBLE) at 2 and 8 weeks post completion of an ACLS provider course. METHODS: A pretest-posttest design was used with 2 emergency department graduate nurse cohorts who participated in an SBLE focused on ACLS components at 2 and 8 weeks after attending the ACLS provider course. Simulation-based learning experiences were videotaped, and outcome measures (ie, time to shock) were measured in seconds. The nurses completed the ACLS written test before and after the SBLE. RESULTS: Most ACLS outcomes improved after SBLE except time to shock. Pretest-posttest ACLS average scores decreased from 93.5% to 77.8% (first cohort) and from 94.5% to 86.7% (second cohort). DISCUSSION: Simulation-based learning experience may be an important adjunct instructing method for teaching new graduates ACLS skills.

A Cognitive Load Theory Simulation Design to Assess and Manage Deteriorating Patients.

Background Cognitive load theory (CLT) uses an understanding of brain architecture for educational design, with implications for simulation. Since working memory is limited, minimising extraneous cognitive load improves learning of new tasks (intrinsic load) and use of existing knowledge (germane load). This study evaluates the effectiveness of low-fidelity simulation (LFS) utilising CLT principles in the assessment and management of the deteriorating patient (AMDP). Method CLT design principles informed the choice of LFS and simulation design. The self-rated ability of 13 undergraduate nurses across seven aspects of AMDP was measured in a pre-post design. Results Self-rated ability increased from 2.98 (SD = 0.19) to 4.47 (SD = 0.12) (p < 0.001), with improvements across all AMDP aspects. Conclusion This study indicates that CLT informed design has benefits for simulation. LFS may be preferred to high fidelity simulation for AMDP teaching and medical simulation for novice learners.

Basic life support for the child and infant.

The majority of cardiorespiratory arrests in children and infants are caused by respiratory insufficiency rather than cardiac problems; therefore, the order of delivering resuscitation is different to the delivery of basic life support to adults. The Nursing and Midwifery Council has stated that all nurses must be able to provide basic life support. This article will explain the process for recognising the need for, and delivering, basic life support to infants and children.

Canulación central de membrana de oxigenación extracorpórea en parada cardiorrespiratoria en postoperados de cirugía cardiaca / Central Cannulation in Extracorporeal Membrane Oxygenation for cardiorespiratory arrest in patients who have undergone cardiac surgery

En los pacientes postoperados de cirugía cardiaca, la mayoría de las paradas cardiorrespiratorias (PCR) requieren una reapertura esternal emergente. Cuando esta situación no revierte, la colocación de un dispositivo de membrana de oxigenación extracorpórea (ECMO) se ha definido como una terapia eficaz para mejorar la supervivencia y disminuir los daños neurológicos. La canulación de ECMO central en estos pacientes supone una opción rápida y segura, aunque es necesaria la formación continua y la realización de guías de procedimiento para que todo el personal pueda actuar de manera rápida y eficaz. El desarrollo de este protocolo tiene como objetivos: a) Estandarizar la secuencia de intervenciones en la colocación de ECMO central en PCR. b) Establecer y definir los roles de cada uno de los profesionales implicados durante el proceso. c) Describir las posibles complicaciones que pueden aparecer para poder prevenir su aparición o minimizar sus consecuencias. d) Identificar los diagnósticos de Enfermería y planificar los cuidados adecuados

In patients who have undergone cardiac surgery, most cardiorespiratory arrests (CRAs) require emergent sternal reopening. When this situation is not reversed, the use of extracorporeal membrane oxygenation (ECMO) has been defined as an effective therapy in order to improve survival and reduce neurological damage. Central ECMO cannulation in these patients represents a fast and safe option, though continuous training is required, as well as preparing procedure guidelines so that all the staff can act in a fast and effective manner. The objectives for developing this protocol are: a) To standardize the sequence of interventions in the placement of central ECMO at CRA; b) To determine and define the roles of each professional involved during the process; c) To describe any potential complications that might appear, in order to prevent them or minimize their consequences; d) To identify nursing diagnoses and determine the adequate plan of care

Nursing roles for in-hospital cardiac arrest response: higher versus lower performing hospitals.

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.

Conhecimento e atuação da equipe de enfermagem de um setor de urgência no evento parada cardiorrespiratória / The knowledge and acting of a nursing team from a sector of cardiorespiratory arrest urgent care / Conocimiento y actuación del equipo de enfermería de un sector de urgencia en el evento parada cardiorrespiratoria

Objective: The study's purpose has been to describe the knowledge and performance of an urgency nursing team of the University Hospital from the Universidade Federal do Vale do São Francisco in Petrolina city, Pernambuco State, with regards to the cardio respiratory arrest event. Methods: It is a descriptive and cross-sectional study with a quantitative approach, which was carried out through a non-probabilistic sample of 101 nursing professionals who answered a questionnaire. Data were analyzed by observing the frequencies of each isolated response and the crossing of variables. Results: Twenty-three nurses and 78 nurse technicians were interviewed. Regarding the detection of a cardio respiratory arrest, immediate conduct, and the actions of both the basic life support and advanced life support, most professionals answered in a partially correct way. Conclusion: The low percentage of totally correct answers evidences the need to update the entire nursing team, maintaining the uniformity of the professional performance, thus improving the care provided to the patient showing serious health condition

Objetivo: Descrever o conhecimento e atuação da equipe de enfermagem da urgência do Hospital Universitário da Universidade Federal do Vale do São Francisco de Petrolina/PE, perante o evento PCR. Métodos: Estudo quantitativo, descritivo e transversal por uma amostragem não probabilística de 101 profissionais de enfermagem que responderam a um questionário. Os dados foram analisados por meio da observação das frequências de cada resposta isolada e do cruzamento de variáveis. Resultados: Foram entrevistados 23 enfermeiros e 78 técnicos de enfermagem. Com relação à detecção de PCR, conduta imediata, ações de SBV e SAV, a maioria dos profissionais respondeu de maneira parcialmente correta. Conclusão: O baixo percentual de respostas totalmente corretas, evidencia a necessidade de atualização de toda a equipe de enfermagem, mantendo a uniformidade das condutas, melhorando assim o atendimento prestado ao paciente grave

Objetivo: Describir el conocimiento y actuación del equipo de enfermería de la urgencia del Hospital Universitario de la Universidad Federal del Valle del São Francisco de Petrolina / PE, ante el evento PCR. Métodos: Estudio cuantitativo, descriptivo y transversal por un muestreo no probabilístico de 101 profesionales de enfermería que respondieron a un cuestionario. Los datos fueron analizados por medio de la observación de las frecuencias de cada respuesta aislada y del cruce de variables. Resultados: Fueron entrevistados 23 enfermeros y 78 técnicos de enfermería. Con respecto a la detección de PCR, conducta inmediata, acciones de SBV y SAV, la mayoría de los profesionales respondió de manera parcialmente correcta. Conclusión: El bajo porcentaje de respuestas totalmente correctas, evidencia la necesidad de actualización de todo el equipo de enfermería, manteniendo la uniformidad de las conductas, mejorando así la atención prestada al paciente grave