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Implementing Cardiac Surgical Unit-Advanced Life Support Through Simulation-Based Learning: A Quality Improvement

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Dimensions of Critical Care Nursing : DCCN
|May 30, 2020
PubMed
Summary

This study implemented a cardiac surgical resuscitation protocol for nurses, improving knowledge and reducing resuscitation delays. While confidence increased, ongoing practice is needed to sustain proficiency and impact patient outcomes.

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Area of Science:

  • Cardiovascular Surgery
  • Intensive Care Nursing
  • Medical Education

Background:

  • Cardiothoracic surgical patients require specific resuscitation protocols (Cardiac Surgical Unit-Advanced Life Support) endorsed by professional societies.
  • Effective implementation necessitates nurses possessing confidence, proficiency, and promptness in protocol execution.
  • Simulation-based learning (SBL) offers an optimal pedagogical approach for skill acquisition in this critical care setting.

Purpose of the Study:

  • To implement a post-cardiac surgery resuscitation protocol in a community medical center.
  • To enhance nurse knowledge, confidence, and proficiency in managing cardiac arrests.
  • To ultimately improve patient outcomes in a cardiothoracic intensive care unit.

Main Methods:

  • Implemented an evidence-based resuscitation protocol using didactic, hands-on training, and SBL.
  • Evaluated the program through knowledge surveys administered at multiple time points.
  • Assessed nurse confidence, performance measures, and patient outcomes, including delays in cardiopulmonary resuscitation.

Main Results:

  • Statistically significant knowledge gains were observed post-implementation (P < .001).
  • Knowledge retention declined at 3 months but remained higher than pre-implementation levels.
  • A significant reduction in delays to cardiopulmonary resuscitation was noted post-education (P = .05).

Conclusions:

  • Didactic and hands-on training effectively supported knowledge retention among cardiothoracic intensive care unit nurses.
  • Simulation-based learning and continued practice are crucial for enhancing self-confidence and protocol application.
  • Further evaluation is required to ascertain the training program's impact on patient outcomes.