Improved Emergency Resternotomy Response Time After a Nurse-Led Multimodal Simulation

Open chest emergencies are high-risk, low-frequency events. Resternotomy procedures should be performed within 5 minutes of a suspected complication. The inability to recognize a complication can delay meeting the 5-minute metric.

To improve nurses' recognition of cardiac tamponade and awareness of equipment needed for resternotomy and to decrease response time from start of cardiac arrest to resternotomy.

In coordination with key stakeholders, the nursing professional development specialist created a 4-hour multimodal education program that included classroom engagement, deliberate practice, and a high-fidelity simulation with detailed prebriefing and debriefing. In 2023 the course was increased to 8 hours to allow for a repeat of the simulation.

A total of 444 nurses participated. The mean (SD) setup time in preparation for sternotomy in 2021 was 311.2 (101.7) seconds, or 5.2 minutes; in 2022 was 323.8 (183.7) seconds, or 5.4 minutes; and in 2023 (after the repeated simulation was added to the course) was 254.8 (170.4) seconds, or 4.2 minutes, which was less than the 5-minute metric.

After attending the course, nurses' response time during simulation of an open chest emergency improved.