BUILDING CAPACITY IN CRITICAL CARE NURSES TO IMPROVE INDIVIDUAL AND TEAM PERFORMANCE IN CARDIOPULMONARY ARREST EVENTS: AN EDUCATIONAL INITIATIVE AND SIMULATION TRAINING

Abstract

The cardiovascular intensive care unit (CICU) at St. Michael’s Hospital is a small ICU (n=10 beds) staffed by 6 nurses on days and 5 nurses on nights. Patients in the CICU often manifest cardiopulmonary emergencies (Code blues) which require highly coordinated and effective performance of the CICU team. There was previously no data available regarding team performance during cardiopulmonary arrest events in the CICU. Additionally, it was not known whether nurses in the unit felt confident in their skills when responding to such events. This performance improvement project set out to measure and improve how nurses respond to code blues in the unit. Nurses’ perceptions and confidence with different skills were assessed through a self-administered questionnaire. Responses revealed gaps in nurses’ technical and non-technical skills necessary to manage a cardiopulmonary arrest event. In addition, team performance was evaluated after each cardiopulmonary arrest by use of the Team Emergency Assessment Measure (TEAM). Various interventions were developed and implemented to target the gaps identified during the initial survey. Code blue simulations were utilized as suggested by the literature. A positive change was noted in nurses’ perceptions post interventions when assessed with the same questionnaire. Observations by team members show increased knowledge and insight regarding effective teamwork. Targeted interventions and code-blue simulations were effective in building individual and team capacity in managing cardiopulmonary arrest events in the CICU. Data on team performance during cardiopulmonary arrest events is being collected continuously and its trend monitored overtime.