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Related Experiment Video

Updated: Jan 6, 2026

Emergency Undocking in Robotic Surgery: A Simulation Curriculum
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Improved Emergency Resternotomy Response Time After a Nurse-Led Multimodal Simulation.

Diane Horabik1, Migdalia Serrano-Smith2, Rachel Wood3

  • 1Diane Horabik is a nursing professional development specialist, Cleveland Clinic, Office of Nursing Education and Professional Development, Cleveland, Ohio.

Critical Care Nurse
|November 30, 2025
PubMed
Summary

A new multimodal education program significantly reduced nurses' response time for open chest emergencies. This training improved recognition of cardiac tamponade and preparation for resternotomy, crucial for critical care.

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Area of Science:

  • Emergency Medicine
  • Nursing Education
  • Surgical Critical Care

Background:

  • Open chest emergencies are rare but high-risk events requiring rapid intervention.
  • A critical time metric for resternotomy is 5 minutes from complication onset.
  • Delayed recognition of complications can impede timely resternotomy procedures.

Purpose of the Study:

  • To enhance nurses' ability to identify cardiac tamponade.
  • To improve nurses' knowledge of necessary resternotomy equipment.
  • To reduce the time from cardiac arrest to resternotomy.

Main Methods:

  • A 4-hour multimodal education program was developed, incorporating classroom learning, deliberate practice, and high-fidelity simulation.
  • The program was expanded to 8 hours in 2023, including repeated simulation sessions.
  • The educational intervention targeted nurses involved in critical care settings.

Main Results:

  • A total of 444 nurses completed the training program.
  • Mean setup time for sternotomy decreased from 5.2 minutes in 2021 and 5.4 minutes in 2022 to 4.2 minutes in 2023.
  • The 2023 setup time was significantly below the 5-minute critical metric.

Conclusions:

  • The multimodal education program effectively improved nurses' response times during simulated open chest emergencies.
  • Enhanced training led to faster preparation for resternotomy, meeting critical time goals.
  • Simulation-based education is a valuable tool for improving critical care response in emergency situations.