Responding to In-hospital Cardiac Arrests During Times of System-wide Strain: A Code Refresher Training

Area of Science:

• Emergency Medicine
• Nursing Education
• Healthcare Management

Background:

• System-wide strain during pandemics correlates with higher in-hospital cardiac arrest (IHCA) rates.
• Medical-surgical nurses may experience skill decay in cardiopulmonary resuscitation (CPR) within three months post-training.
• Heightened anxiety during pandemic surges can negatively impact nurses' concentration and confidence in managing critical events.

Purpose of the Study:

• To evaluate the effectiveness of a brief mock code training refresher for medical-surgical nurses.
• To enhance nurses' confidence in performing CPR while adhering to pandemic safety protocols.
• To assess the impact of refresher training on nurses' self-efficacy in managing in-hospital cardiac arrests.

Main Methods:

• A 45-minute mock code training refresher was provided to medical-surgical nurses.
• A pre-post clinical education project design was employed.
• Nurses' confidence was measured using the Nursing Anxiety and Self-Confidence with Clinical Decision Making© Scale.

Main Results:

• Participants verbally reported increased confidence in initiating resuscitation post-training.
• Nurses indicated improved confidence in collaborating with team members during mock codes.
• Self-reported confidence in using personal protective equipment (PPE) during resuscitation also increased.

Conclusions:

• A significant percentage of registered nurses (RNs) lack adequate confidence and competence in CPR, especially during system-wide strain.
• Brief, cost-effective refresher training shows promise in improving nurses' preparedness for IHCA.
• Further research is warranted to validate the efficacy of such refresher training interventions.