Authors (including presenting author) :
Kwok H Y, Wut O L, Au-Yeung Y W, Szeto M Y, Wu Y W
Affiliation :
Department of Cardiothoracic Surgery
Introduction :
Emergency re-sternotomy is a critical component of cardiac arrest management following cardiac surgery. Complications that may necessitate this procedure include: tamponade, hemorrhage and cardiac arrest. Prompt re-sternotomy allows relieving of tamponade and facilitates internal cardiac massage (ICM). Early recognition of these life-threatening situations and timely response can improve patient’s survival rate. However, emergency re-sternotomy is an infrequent event which nurses rarely have the clinical experience to assist with. Therefore, the development of simulation based training on emergency re-sternotomy is necessary to enhance nurse preparedness for this infrequent but crucial condition.
Objectives :
To familiarize with the procedure of emergency re-sternotomy
To identify nurse’s role in emergency re-sternotomy
To improve team response to emergency re-sternotomy
To familiarize with the use of the equipment during emergency
Methodology :
to emergency re-sternotomy
To familiarize with the use of the equipment during emergency
Methodology
Nurses from all ranks with or without the experience of emergency re-sternotomy were recruited. Nurses are assigned to different role to participate in the emergency re-sternotomy training. After finish the simulation based training, there are skill stations for the nurses to have return demonstration on how to operate the equipment used in the procedure. Program evaluation form are used to evaluate the effectiveness of the training.
Result & Outcome :
Over 75% of nurses in the department have attended the training. The overall comments were satisfactory. Nurses had a clear concept on role delineation. Familiarization of the procedure and equipment used is improved. Nurses expressed feeling competency to perform emergency re-sternotomy in future.
Nurses also left positive comments in the evaluation form such as ‘fruitful opinion and practical knowledge from the facilitator, practical training, etc.’ Nurses were highly appreciated that the skill station gave them the opportunities to have hands on experience in operating the equipment needed for the procedure. Nurses who never participate in the emergency re-sternotomy have a preliminary concept on this rare situation after training.
Way forward
Regular simulation training will be carried out to strengthen the skill and knowledge of nurses and to safeguard patient safety. Video demonstration reveals a more convenience method and acts as an alternative training material on this procedure which will be produced to meet the long term training needs.
