Life Support Skills Research Articles

Evaluation of basic life support education for high school students in a city in brazil

Abstract Funding Acknowledgements Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): The researchers themselves. Background Cardiorespiratory Arrest (CRP) is a medical emergency that requires urgent aid as well as technical skills to initiate Cardiopulmonary Resuscitation (CPR) maneuvers, primarily among the lay population, seeing as the majority of CRP episodes take place in community environments. Purpose: The purpose of this study is to compare the Basic Life Support (BLS) skills of high school students before and after a theoretical-practical approach. Method: A quasi-experimental study was conducted, consisting of theoretical-practical training on BLS running 60 minutes total (20 minutes of theory and 40 minutes of practice), addressing various steps in layman’s out-of-hospital BLS. Evaluations were conducted before and after training. The instrument was developed by the researchers themselves and underwent a previous validation process. The statistical software employed for the purpose of analyzing the data was SPSS version 21.0 for Windows. At the outset, descriptive statistics were employed to present the data, as well as the Wilcoxon test to compare the results of questionnaires taken before and after the intervention. Results: The sample consisted of 322 students from private institutions in Belo Horizonte, Brazil. The median age was 16.0 years, with an interquartile interval (IQ) of 2 years, with 181 (56.2%) students being female and 141 (43.8%) male. The before and after results revealed statistically significant differences in performance: pre-training – median = 5 points, IQ = 2 points; post training – 9 points, IQ = 2 points; p < 0.0001. Conclusion: The conduction of theoretical-practical classes was followed by an increase in correct answers to the BLS questionnaire. The results suggest that simple educational strategies might aid in the training of lay young people to respond correctly to CRP scenarios.

Evaluation of basic life support education for high school students in a city in brazil

Abstract Funding Acknowledgements Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): The researchers themselves. Background Cardiorespiratory Arrest (CRP) is a medical emergency that requires urgent aid as well as technical skills to initiate Cardiopulmonary Resuscitation (CPR) maneuvers, primarily among the lay population, seeing as the majority of CRP episodes take place in community environments. Purpose The purpose of this study is to compare the Basic Life Support (BLS) skills of high school students before and after a theoretical-practical approach. Method A quasi-experimental study was conducted, consisting of theoretical-practical training on BLS running 60 minutes total (20 minutes of theory and 40 minutes of practice), addressing various steps in layman’s out-of-hospital BLS. Evaluations were conducted before and after training. The instrument was developed by the researchers themselves and underwent a previous validation process. The statistical software employed for the purpose of analyzing the data was SPSS version 21.0 for Windows. At the outset, descriptive statistics were employed to present the data, as well as the Wilcoxon test to compare the results of questionnaires taken before and after the intervention. Results The sample consisted of 322 students from private institutions in Brazil. The median age was 16.0 years, with an interquartile interval (IQ) of 2 years, with 181 (56.2%) students being female and 141 (43.8%) male. The before and after results revealed statistically significant differences in performance: pre-training – median = 5 points, IQ = 2 points; post training – 9 points, IQ = 2 points; p < 0.0001. Conclusion: The conduction of theoretical-practical classes was followed by an increase in correct answers to the BLS questionnaire. The results suggest that simple educational strategies might aid in the training of lay young people to respond correctly to CRP scenarios.

Comparison of Four Methods of Paramedic Continuing Education in the Management of Pediatric Emergencies

Introduction: Finite resources limit the amount of time EMS agencies can dedicate to continuing education in pediatric emergencies. EMS instructors need effective, efficient, and affordable educational strategies for these high-risk, low frequency events. Objective: To compare the effectiveness of four training methods in management of pediatric emergencies for paramedics. Methods: A validated, performance-based, simulated clinical assessment module was used to provide a baseline measurement of paramedics’ resuscitation skills during three simulated pediatric emergencies. Educational modules were developed that targeted deficiencies identified by the baseline assessment, including advanced pediatric life support skills, airway management, use of the Broselow-Luten Tape®, pediatric drug dose calculations and drug delivery, seizure management, and trauma assessment. Paramedics from five EMS agencies in Michigan were randomized to four education intervention groups. The control group used an existing, online, continuing education course. Three experimental groups were exposed to the same content during five, one-hour sessions conducted over 2.5 years. Instruction was delivered using high-fidelity, simulated case-based training, low-fidelity simulation training, or lecture with procedural skills lab, based on group assignment. After the training, all groups were tested within 4–6 months using methods identical to baseline testing. Results: One hundred forty-seven subjects completed the study. There were no differences in baseline skill levels among the four groups. Only the low fidelity simulation training group demonstrated improvement of combined scenario scores (p = 0.0008). Scores for targeted skills improved in one scenario in the high-fidelity group, two in the low-fidelity group, one in the lecture/lab group, and none in the control group. Conclusions: Although improvements in those skills included in the training were found in three groups, two hours of training in pediatric emergencies per year was insufficient to produce a substantial improvement overall. Expensive, high-fidelity simulators were not necessary for teaching pediatric resuscitation skills to paramedics; instructive scenarios using low-fidelity manikins and debriefings appear to be adequate. The content delivered by an online refresher course did not provide any improvement in performance as measured by simulated, case-based assessments.

Basic life support skills can be improved among certified basic life support instructors

BackgroundA correct visual skill demonstration is important when learning cardiopulmonary resuscitation (CPR) and the use of an automated external defibrillator (AED). Basic life support (BLS) instructors are expected to master and demonstrate CPR/AED skills correctly. The aim of this study was to evaluate certified BLS instructors’ competencies in demonstrating CPR and the use of an AED. MethodsCertified BLS instructors demonstrated CPR and the use of an AED on a resuscitation manikin. Skills were evaluated using data collected from the manikin and video recordings and compared to resuscitation guidelines. Further, instructors completed questionnaires on resuscitation guidelines and rating of their own CPR/AED skills. ResultsOverall, we analyzed data from 125 instructors. Of all chest compressions, only 22% were within guideline recommendations regarding depth. Instructors performed chest compressions with excessive depth (mean depth 64mm (7.3)) and a mean rate of 115min−1 (10.8). Only 25% of instructors placed the left AED electrode correctly (median distance 7.6cm (5.0;10.5)), while the right AED electrode usually was placed correctly (median distance 2.9cm (1.5;4.0), 85% placed correctly). Nearly half of the instructors failed to state correct answers regarding how to diagnose a cardiac arrest and where to place the AED electrodes. Despite their performance, instructors rated their BLS skills as good. ConclusionCertified BLS instructors’ have poor CPR/AED skills and several important knowledge gaps on CPR/AED guidelines in contrast to instructors’ self-reported skills. This highlights a need for improving BLS instructor education, including continuous faculty development to ensure optimal learning conditions for BLS course participants.

Adhering to Social Distancing Rules Using a "Split Patient" Model With Rapid Cycle Deliberate Practice in Pediatric High-Fidelity Simulations.

The coronavirus disease 2019 (COVID-19) pandemic has required simulation-based medical education to adapt to physical distancing regulations in order to protect learners and facilitators. The “split patient” model allows for physical distancing of learners in pediatric high-fidelity simulations. This model was able to be used with the Rapid Cycle Deliberate Practice to teach pediatric residents basic and advanced life support skills and the principles of Crisis Resource Management.

Improving the Appropriateness of Advanced Life Support Teams' Dispatch: A Before-After Study.

The dispatch of Advanced Life Support (ALS) teams in Emergency Medical Services (EMS) is still a hardly studied aspect of prehospital emergency logistics. In 2015, the dispatch algorithm of Emilia Est Emergency Operation Centre (EE-EOC) was implemented and the dispatch of ALS teams was changed from primary to secondary based on triage of dispatched vehicles for high-priority interventions when teams with Immediate Life Support (ILS) skills were dispatched. This study aimed to evaluate the effects on the appropriateness of ALS teams' intervention and their employment time, and to compare sensitivity and specificity of the algorithm implementation. This was a retrospective before-after observational study. Primary dispatches managed by EE-EOC involving ambulances and/or ALS teams were included. Two groups were created on the basis of the years of intervention (2013-2014 versus 2017-2018). A switch from primary to secondary dispatch of ALS teams in case of high-priority dispatches managed by ILS teams was implemented. Appropriateness of ALS team intervention, total task time of ALS vehicles, and sensitivity and specificity of the algorithm were reviewed. The study included 242,501 emergency calls that generated 56,567 red code dispatches. The new algorithm significantly increased global sensitivity and specificity of the system in terms of recognition of potential need of ALS intervention and the specificity of primary ALS dispatch. The appropriateness of ALS intervention was significantly increased; total tasking time per day for ALS and the number of critical dispatches without ALS available were reduced. The revision of the dispatch criteria and the extension of the two-tiered dispatch for ALS teams significantly increased the appropriateness of ALS intervention and reduced both the global tasking time and the number of high-priority dispatches without ALS teams available.

Knowledge and Skills of Cardiopulmonary Resuscitation among Critical Care Nurses in Kuwaiti Hospitals

Background: The ability of nurses and the other health care professionals to deal with cardiac arrest effectively depends largely on their knowledge and skills regarding the cardiopulmonary resuscitation (CPR) procedure. Purpose: The purpose of this study was to identify the level of knowledge and skills about CPR and the factors influencing the level of CPR knowledge and skills among critical care nurses in Kuwait. Methods: To meet the purpose of this study, a descriptive, cross-sectional, and correlational design was used. A sample of 204 critical care nurses from two governmental hospitals completed the study. Three instruments were used to collect data, including the demographic questionnaire, the CPR certification exam quiz, and the Basic Life Support Skills Checklist. Results: About 56.4% of the study participants passed the skills exam about CPR. However, only 15.7% passed the knowledge test about CPR. Better CPR Knowledge was associated with working in Hospital 2, receiving formal training in CPR, and being AHA certified. Better CPR skills was related to working in Hospital 2, male gender, experience in nursing, experience in travelling with patients for seeking treatment outside Kuwait, being AHA certified, and receiving formal training in CPR (P<0.05). Conclusion: Frequent education and training in CPR in the hospital and having CPR accreditation from AHA are required for critical care nurses in order to increase their ability to save the life of critically ill patients who are at risk for cardiac arrest.

Graduates’ and Employers’ Perceptions on Competencies Obtained from An Undergraduate Dental Curriculum

Introduction Measuring the effectiveness of a dental curriculum as reflected by the competencies of the graduates is paramount in ensuring the curriculum remains relevant in the rapidly evolving field of dentistry. We aimed to assess the competencies of dental graduates of Faculty of Dentistry, Universiti Kebangsaan Malaysia (UKM) as perceived by the graduates and their employers, based on the core competencies listed in the UKM undergraduate dental curriculum. Methods A self-administered questionnaire consisting of 43 questions based on eight domains of competencies were sent to all UKM dental graduates of years 2012 to 2015 as well as senior dental officers who represented their employers. Findings 132 out of 177 graduates (75%) and 18 out of 33 employers (55%) responded. Most graduates felt competent in gathering information and all employers agreed that the graduates were competent with this skill. Out of the eight domains, only community based domain was collectively rated ‘poor’ by the employers while the rest of the domains had an ‘excellent’ rating by both the graduates and their employers. However, based on the individual skill, basic life support skill was rated very low for both groups (38.6% graduates and 23.5% employers). The employers underrated the graduates in the domain of treatment and prevention, community-based, management and administrative, and communication. Significance The findings of this study allow an evaluation of the curriculum in a myriad of angles. Although the graduates reported a good level of competency in most domains, the employers were reserved on the community-based skills. This needs to be addressed in order to improve the undergraduate program.

Pharmacology education on women's health, pregnancy, childbirth and breastfeeding in Midwifery education

Midwives are responsible professionals who support the sexual and reproductive health, rights, and welfare of individuals, families, and communities. In particular, midwives work in partnership with women to provide the necessary support, care and advice needed during pregnancy, childbirth and the postpartum period. Midwives conduct normal births on her own responsibility, support breastfeeding, provide care for newborns and infants, and fully release mother-infant's latent strengths. Midwives also contribute in adopting appropriate preventative measures to promote normal birth and breastfeeding, detecting early signs of complications, and carrying out emergency measures or transferring the patient to other medical care or assistance as needed. In order to provide the best care to mother and infant, midwives should first learn the biological foundations of women's health, pregnancy, childbirth, postpartum, breastfeeding, and infant health. They must also understand the in vivo mechanisms and actions of the key hormones and neurotransmitters in play during the reproductive period. Additionally, midwives need to learn pharmaceutical treatments to complement and support biological function in cases of disorders or impairments occurring in women and infants. Midwives should also be competent in life support skills in obstetrics and neonatal cardiopulmonary resuscitation. The directors of Japanese Maternity Centers sign a contract with obstetricians that permits them to purchase and use emergency medicines. We facilitate midwifery students in their studies of medicine and pharmacology in order to train them to cope with such emergency situations. In this revision of the midwifery curriculum and the continuing education, we hope to create a new midwifery educational program focusing on personalized, client-centered pharmacology, with the ultimate objective to support and maintain the health of women, mothers, infants, child-rearing families, and communities.

Awareness, Knowledge, and Attitude of Saudi Students towards Basic Life Support: A Cross-Sectional Study

Objective: To evaluate the knowledge and attitude in relation to basic life support (BLS) and cardiopulmonary resuscitation (CPR) skills among the dental undergraduates and interns in Sakaka, Saudi Arabia . Material and Methods: This cross-sectional study was undertaken between October 2019 and December 2019 in Sakaka, Saudi Arabia. One hundred and eighty randomly selected dental students aged over 18 years participated in the study. Their knowledge and attitude towards BLS were gathered through a questionnaire. Results: A total of 158 (out of 180) UG students and interns participated in this study, making the responses of 87.8%. The mean age of the participants was 24.6 years. The samples comprised 86 (54.4%) males and 72 (45.6%) females. The assessments showed that overall the participants had average knowledge towards BLS and CPR, with males responding significantly better than the females (p ˂ 0.05). Furthermore, as students climb the academic ladder, their knowledge regarding BLS and CPR tends to rise. Also, their attitude was positive, and they were willing to receive CPR training . Conclusion: Attitude toward acquiring knowledge about CPR was very positive. However, their knowledge about the topic was average. Students should understand the importance of such skills and efficiently involve in these life-saving procedures.

Simulation-based medical education for Ambulance Jet and Helicopter Emergency Medical Services: A program description and evaluation.

This article was migrated. The article was marked as recommended. Introduction: In aviation, crew resource management trainings are established methods to enhance safety, a method that also gained popularity in medicine. In 2015, the Swiss Air Rescue (Rega) Helicopter Emergency Medical Services decided to start a simulation-based medical education program for its helicopter and ambulance jet crews (emergency physicians, paramedics/flight nurses and pilots). The aim of this program was to improve technical skills and the application of human factors during rescue missions. This report shows a five-year summary of the participants' course evaluation. Methods: A 1-day high-fidelity simulation on crisis resource management with video-assisted debriefing took place at 3 centres, two in Switzerland; one in Germany. Crew members participated once per year. Simulation covered critical situations in the helicopter or jet, during handovers at an intensive care unit or in ambulances. Extra Corporeal Membrane Oxygenation and Intra-Aortic Balloon Pump use was simulated during helicopter transports. Additionally, four times per year flight crews rehearsed basic and advanced life support skills using low-fidelity equipment between missions. Participants answered an anonymized course evaluation survey. Answers were rated on a Numeric Rating Scale ranging from 1=no agreement to 5=total agreement. Results: 329 participated and answered the questionnaire; 50% were emergency physicians, 40% paramedics, 9% flight nurses, and 1% pilots. Participants agreed that the course taught competencies that were useful for their clinical practice. However, confidence to apply Extra Corporeal Membrane Oxygenation or Intra-Aortic Balloon Pump skills was significantly lower compared to other emergency competencies. Instructors were rated as experienced, engaged and motivated, as well as responsive to course participants. Conclusions: This simulation-based medical education program, with the goal to increase patient's safety and outcome, was launched successfully. Participants especially valued the time to reflect on clinical performance as well as on crew interaction and ways to apply human factors to improve their team performance and task management.

Basic Foundation Course for the Students of Allied Health Sciences

The MBBS students have to undergo a one-month-long Foundation course as per the new curriculum put forth by the Medical Council of India. With this in mind we conducted a basic Foundation course of four days duration for the students of Allied Health Sciences covering various important topics related to physical and mental health communication and behavior life support skills and safety and technology. The students enjoyed it and found it helpful. This could be a good adjunct to the course.nbsp

Low Competency in Basic Life Support Skills of Graduating Medical Students

Low Competency in Basic Life Support Skills of Graduating Medical Students

Arandomised trial of the effectiveness of instructor versus automated manikin feedback for training junior doctors in life support skills.

IntroductionAustralian Standards require that clinicians undergo regular training in skills required to respond to the acute deterioration of a patient. Training focuses on the ability to appropriately respond to cardiac arrest, including delivering cardiac compressions, ventilation and appropriate defibrillation. Providing such training comes at a significant cost to the organisation and impacts on clinician time in direct patient care. If effective, the use of an automated manikin could significantly reduce costs and provide consistent training experiences.MethodsFifty-six resident medical officers were randomised to two groups to test two skills components of hospital life support training under two feedback conditions. The skills components were cardiac compressions and bag-valve-mask ventilation. The feedback conditions were automated feedback delivered by a simulation manikin and traditional feedback delivered by an instructor. All participants were exposed to both skills components and both feedback conditions in a counterbalanced block design. Participants completed surveys before and after training.ResultsThe results demonstrated significantly better performance in cardiac compressions under the automated manikin feedback condition compared with the instructor feedback condition. This difference was not observed in bag-valve-mask ventilation. The majority of participants found the automated manikin feedback more useful than the instructor feedback.DiscussionAutomated manikin feedback was not inferior to instructor feedback for skill acquisition in cardiac compressions training. The automated feedback condition did not achieve the same level of significance in bag-valve-mask ventilation training. Results suggest training with automated feedback presents a cost-effective opportunity to lessen the training burden, whilst improving skill acquisition.Electronic supplementary materialThe online version of this article (10.1007/s40037-020-00631-y) contains supplementary material, which is available to authorized users.

Effects of pre-course preparation using a serious smartphone game on advanced life support knowledge and skills -A randomized controlled trial

Abstract Background Over the past several years, gamified learning has been growing in popularity in various medical educational contexts including cardiopulmonary resuscitation (CPR) training. Furthermore, prior work in Basic Life Support (BLS) training has demonstrated the benefits of serious games as a method for pre-training among medical students. However, there is little evidence to support these benefits with regard to Advanced Life Support (ALS) training Objective We compare the effects of a brief pre-course ALS preparation course using a serious smartphone game on students' knowledge, skills, and perceptions in this area with those of conventional ALS training alone. Methods A serious game (Resus Days) was developed by a Thai physician based on global ALS clinical practice guidelines. Fifth-year medical students were enrolled and randomized to either a game group or a control group. Participants in both groups attended a traditional ALS lecture, but the game group was assigned to play Resus Days for 1 hour before attending the lecture and as wished after that. All students underwent conventional ALS training, and their abilities were evaluated using multiple choice questions and with hands-on practice on a mannequin. Subjects' attitudes and perceptions about the game were evaluated using a questionnaire. Results A total of 105 students participated in the study and were randomly assigned to either the game group (n=52) or the control group (n=53). Students in the game group performed better on the ALS algorithm knowledge posttest than those in the control group (17.22±1.93 vs 16.60±1.97, P=0.01; adjusted mean difference [AMD] 0.93, 95% CI 0.21–1.66;). The game group's pass rate on the skill test was also higher, but not to a statistically significant extent (79% vs 66%, P=0.09; adjusted odds ratio [AOR] 2.22, 95% CI 0.89–5.51). Students also indicated high satisfaction with the game (9.02±1.11 out of 10). Conclusions Engaging in game-based preparation prior to an ALS training course resulted in greater medical students' algorithm knowledge scores than attending the course alone. A screen shot of Resus Days Funding Acknowledgement Type of funding source: None

Awareness and attitude of final year students towards the learning and practice of cardiopulmonary resuscitation at the University of Ibadan in Nigeria.

IntroductionOut-of-hospital cardiac arrest (OHCA) is a major cause of sudden cardiac death which can be prevented by early cardiopulmonary resuscitation (CPR). International bodies recommend that basic life support (BLS) skills be taught in schools in order to increase the rate of bystander CPR and reduce mortality from OHCA. We are not aware of any BLS education program for non-healthcare students in Nigeria. This study was to assess the awareness and attitude to acquiring BLS skills among university students.MethodsWe conducted a cross-sectional study among final year university undergraduates using a questionnaire that assessed students' sociodemographic characteristics, awareness of CPR, previous experiences, and attitude to basic life support (BLS). Counts and proportions were compared for the demographic characteristics using Chi-squared and Fisher's exact tests.ResultsFour hundred and seventy-five students from 15 faculties participated in this study, median age was 22.8 years (interquartile range: 21.2–24.5 years). Majority (82.5%) have heard of CPR, 29.7% have undergone CPR training; 77.3% of those who had been trained were confident that they could perform CPR. Previous CPR training was significantly associated with faculty, year of study and age. Eighty-nine (18.7%) students have witnessed someone die from a trauma. Four hundred and fifty (94.7%) respondents would like to get BLS training, 440 (92.6%) think that CPR training should be included in the school curriculum.ConclusionThere is good awareness and positive attitude to the acquisition and practice of cardiopulmonary resuscitation among university students in Nigeria. Few students however, have been trained to administer bystander cardiopulmonary resuscitation. Therefore, there is a need to implement university wide BLS education in Nigeria.

Relationship between knowledge and skill for basic life support in personnel of emergency medical services, Islamic Republic of Iran.

Pre-hospital resuscitation in cardiac arrest is crucial to survival of patients, so emergency medical services personnel must have up-to-date knowledge and good skills. This study aimed to determine the association between knowledge and skills of emergency medical services personnel of basic life support in north-west Khuzestan province, Islamic Republic of Iran. This cross-sectional study included all personnel of emergency medical services (75 participants) in two emergency centres. Data were collected on characteristics of the participants (age, time since last retraining, academic degree, and length of experience), and their knowledge of basic life support. Skills were assessed by observing the personnel carry out basic life support and use of an automated external defibrillator on a mannequin. Poor knowledge was found in 31% of the personnel (mean score: 19.35 (SD 3.9); range: 0-34) and 42.7% had poor skills (mean score: 5.40 (SD 2.39); range: 0-9). Most of the staff (71%) did not use the automated external defibrillator correctly. No statistically significant relationship was found between staff knowledge and skills (P = 0.298). Staff knowledge and skills were significantly associated with correct use of the defibrillator (P = 0.039). Knowledge score was significantly associated with length of time since doing resuscitation training (P = 0.006) and academic qualification (P = 0.046). The skills score was significantly associated with time since doing training (P = 0.004). Strategies to maintain and improve the life support knowledge and skills of personnel in emergency medical services are recommended.

Effect of Interactive Computer Based and Traditional Instructor-Led Based Training of Basic Life Support Programs among Healthcare Providers

Background: Basic Life Support is a specialized training program which enables the healthcare workers to refresh their knowledge & skills for having up-to-minute information in this regard. This life saving skill training is evolving with introduction of new technological advances in teaching of healthcare personnel. It is not possible for the trainers to remain isolated from using the new training methods of such life-saving emergency care. Therefore, it was necessary to evaluate the current methods for Basic Life Support training for nurses with interactive computer-based training. Objective: To evaluate the effects of interactive computer based training and traditional instructor-Led based training of (BLS) among nurses. Study Design: Cross-sectional study. Settings & Duration: Study was conducted in Lahore School of Nursing (LSN), University of Lahore for a period of nine months. Methodology: Eighty-four practicing nurses were enrolled in the study & two interventional groups were made having forty-two practicing nurses in each group. One group was traditional and other was computer based. Information obtained directly from participants. Twenty-five multiple item questionnaire & checklists were used according to the guidelines of American Heart Association. Data analyzed by using SPSS version 21. Results: The mean value of pre computer and pre traditional knowledge score was 9.26± 3.891 and 11 ±4 .708, with mean difference, p-value= 0.000(<0.05). The mean value of pre computer and post computer knowledge score was 9.26± 3.891 and 20.11 ± 5.454, with mean difference, p-value= 0.000 (<0.05). The mean value of pre traditional and post traditional knowledge score was 11.12± 4.708 and 22.76 ± 2.216, with mean difference, p-value= 0.000 (<0.05). The mean value of Post computer and post Traditional knowledge score was 20.11± 5.454 and 22.76 ± 2.216, with mean difference, p-value= 0.011 (< 0.05). Conclusion: Both interventional groups were helpful for acquiring or improving the knowledge and skills of Basic Life Support but the traditional instructor-led based training programs were more effective than computer-based training program.

Deliberate Practice in Simulation: Evaluation of Repetitive Code Training on Nursing Students’ BLS Team Skills

BackgroundBasic life support (BLS) skills decline rapidly without frequent practice. Deliberate practice (DP) and simulation scenarios have been shown to increase BLS skill retention for nursing students. In addition, BLS implementation in the hospital setting requires effective team skills, which are infrequently addressed in resuscitation courses or in nursing students’ practice. An exploratory study to determine the impact of recurrent simulations with DP on BLS team skills was designed for senior nursing students. MethodSeven teams of students were followed over the course of one semester examining the impact of DP in recurrent simulation codes on BLS team skills. ResultsStudents attained effective BLS team performance after three hours of DP and sustained these skills over the semester with recurrent code practice. ConclusionRecurring code team DP sustains BLS skills and is recommended for nursing students.

37. RAPID CYCLE DELIBERATE PRACTICE SIMULATION FOR RESIDENT EDUCATION AT A COMMUNITY HOSPITAL SITE

Background Community hospitals offer opportunity for increased pediatric resident autonomy yet may require more direct use of resuscitation skills than more resource-rich settings. Rapid cycle deliberate practice (RCDP) simulation teaches critical skill mastery using feedback-replay loops and can be used for resident education. Objective: We sought to establish a RCDP simulation program and improve pediatric residents’ preparation to handle medical emergencies at our community hospital training site. Methods We designed and conducted high fidelity RCDP simulation every 2 weeks on the community hospital ward. RCDP led by trained faculty and chief residents focused on Pediatric Advanced Life Support skills and activating clinical support for pediatric respiratory distress. Resident physicians on rotation at the community hospital (Bridgeport) and on duty nurses participated. We later asked all 35 resident participants to complete an anonymous web-based survey to assess non-simulated and simulated pediatric code experience. 2 open-ended questions assessed RCDP experience and its impact on the community hospital rotation. We performed descriptive statistics and qualitative thematic analysis by 2 reviewers to identify themes of residents’ experiences. Results 77% (n=27) of residents responded. 68% had participated in at least one non-simulated pediatric code during residency; 43% in 1-2, 18% in 3-5, and 7% in >5. Yale New Haven (YNH) PICU was the most common location of code participation (47%, n=14), 17% (n=5) at the Bridgeport ED, 13% (n=4) at the YNH Pediatric ED, 7% (n=2) on a YNH ward, and 7% (n=2) on the Bridgeport ward. Only 1 resident had ever acted as team leader in a pediatric code. 4 major themes of resident experience were identified: practical community-hospital specific preparation, teamwork, improved confidence, and helpful formative feedback. Conclusions We established a community hospital-focused RCDP simulation program. Residents report that RCDP provided relevant, practical preparation and improved confidence in the ability to deal with respiratory distress at the community hospital site.