Improving Left Ventricular Assist Device Competency in Emergency Nurses Using Quarterly Skills Check and Simulation

Heart failure is a progressive disease that affects more than 6.7 million people in the United States and has a 50% mortality rate. A left ventricular assist device provides an option to many patients with heart failure as a bridge to either transplantation or destination therapy. Patients are becoming more prevalent with improved survival rates. Emergency nurses must have a basic understanding and skills to provide high-quality care. The competency program aims to elevate the confidence of emergency nurses caring for left ventricular assist device patients and reduce the reliance on the circulatory support technician through quarterly skills assessment and simulation.

A quality improvement project was implemented using quarterly assessments of skills and confidence perception surveys.

The competency program resulted in an increased confidence perception for every skill: changing batteries, exchanging controllers, transporting left ventricular assist device patients, and identifying alarms with appropriate intervention. Overall, 35.6% of nurses felt confident caring for left ventricular assist device patients during baseline data collection, 13.3% during the midyear session, and 75.6% during the final education session.

The quality improvement project identified a need to provide additional support to emergency nurses to increase their skills and confidence. Replication is needed to assess further the efficacy of more frequent simulation-based learning and the implementation of readily available resource books and left ventricular assist device nurse champions.