Authors (including presenting author) :
HUNG C.K., SHIU Y.H., WONG L.Y., LEUNG K.N.S. & CTSD CPR Team
Affiliation :
Cardiothoracic Surgical Department, Queen Mary Hospital
Introduction :
Cardiac arrest was life-threatening, where the patients in CTSD were ranked as the top incident rate in various studies, but it could be reversible if high-quality cardiopulmonary resuscitation (CPR) was promptly initiated and performed. Junior nurses frequent expressed anxiety and confusion during CPR. Delayed initiation and poor quality were reported in overseas studies and affected patients' outcomes. As of August 2019, there were 34 junior nurses who were under the preceptorship program without resuscitation experience.
In order to maintain high-quality CPR, a low-dose, high-frequency CPR simulation program was designed. It was an in-situ continuous short-duration simulation-based competency-building approach training that was recommended in the resuscitation quality improvement plan of the AHA consensus statement.
Objectives :
To improve confidence and competence in performing resuscitation among junior nurses
To develop an evidence-based resuscitation training kit for the preceptorship training program
Methodology :
All CTSD nurses under the preceptorship program were recruited. They received a 1-hour resuscitation refresher training every 4 months for a year. It comprised of the following: (1) Individual chest-compression practice for 2 minutes; (2) Infection control update for COVID-19; (3) Mini-lectures on assisting intubation, role division, defibrillation and emergency medication; (4) A 15-minute IHCA scenario-based simulation and (5) Debriefing. Each session included 4-5 participants for a better role distribution.
A quasi-experimental program was designed and evaluated by pre- and post-test surveys, which consisted of 13 questions regarding self-competence and self-confidence. A paired t-test was used to analyze and compare the mean score between the pre- and post-test.
Result & Outcome :
The program was completed by 27 participants (n=27). In addition, 22 simulation training sessions were conducted between February 2020 to February 2021. A significant improvement in both self-competence and self-confidence was found after 1 year of training. The mean of self-competence and self-confidence increased from 28.2 to 35.7 (p< 0.01) (total score: 40) and from 13.5 to 20.7 (p< 0.03) (Total score: 25) respectively. All sub-questions were reported with positive improvement.
The low-dose, high-frequency CPR simulation program was effective in improving confidence and competence among junior nurses. Therefore, this program should be encouraged, promoted and sustained.
