Simulation Training for Emergency Sternotomy in the Cardiovascular Intensive Care Unit

Area of Science:

• Critical Care Medicine
• Surgical Education
• Quality Improvement

Background:

• Emergency resternotomy in the intensive care unit (ICU) post-cardiac surgery presents significant challenges due to unfamiliarity with necessary instruments and techniques among staff.
• Suboptimal performance and outcomes following an initial emergency ICU resternotomy highlighted the need for improved protocols.

Purpose of the Study:

• To enhance staff comfort, familiarity, and preparedness for emergency resternotomy procedures within the ICU setting.
• To streamline emergency sternotomy protocols and improve team response through targeted training.

Main Methods:

• Implementation of an education and simulation training program focused on emergency resternotomy.
• Training included hands-on simulations, familiarization with specialized resternotomy trays, and protocol review.
• Pre- and post-intervention surveys assessed staff familiarity with plans, algorithms, and roles.

Main Results:

• Post-intervention, 95% of staff felt prepared for emergency ICU sternotomy, a significant increase from 52% pre-intervention.
• Preparedness in identifying patients needing emergency sternotomy rose from 50% to 95%.
• Improved understanding of team roles, protocol activation, and resuscitation guidelines was observed.

Conclusions:

• Simulation-based training is an effective strategy for enhancing staff comfort and comprehension of emergency resternotomy procedures.
• Quality improvement initiatives incorporating simulation can positively impact readiness for critical surgical events in the ICU.