In situ simulation-based team training for post-cardiac surgical emergency chest reopen in the intensive care unit

被引:35
作者
Nunnink, L. [1 ,2 ]
Welsh, A. -M.
Abbey, M.
Buschel, C.
机构
[1] Princess Alexandra Hosp, Intens Care Unit, Woolloongabba, Qld 4102, Australia
[2] Univ Queensland, Brisbane, Qld 4072, Australia
关键词
cardiac surgery; repeat sternotomy; training; simulator; RESUSCITATION; MEDICINE; AUDIT;
D O I
10.1177/0310057X0903700109
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Emergency chest reopen of the post cardiac surgical patient in the intensive care unit is a high-stakes but infrequent procedure which requires a high-level team response and a unique skill set. We evaluated the impact on knowledge and confidence of team-based chest reopen training using a patient simulator compared with standard video-based training. We evaluated 49 medical and nursing participants before and after training using a multiple choice questions test and a questionnaire of self-reported confidence in performing or assisting with emergency reopen. Both video- and simulation-based training significantly improved results in objective and subjective domains. Although the post-test scores did not differ between the groups for either the objective (P=0.28) or the subjective measures (P=0.92), the simulation-based training produced a numerically larger improvement in both domains. In a multiple choice question out of 10, participants improved by a mean of 1.9 marks with manikin-based training compared to 0.9 with video training (P=0.03). On a questionnaire out of 20 assessing subjective levels of confidence, scores improved by 3.9 with manikin training compared to 1.2 with video training (P=0.002). Simulation-based training appeared to be at least as effective as video-based training in improving both knowledge and confidence in post cardiac surgical emergency resternotomy.
引用
收藏
页码:74 / 78
页数:5
相关论文
共 13 条
[1]  
Angood PB, 2006, UPD INT CAR, V43, P389
[2]   The Cardiac Surgery Advanced Life Support Course (CALS): Delivering significant improvements in emergency cardiothoracic care [J].
Dunning, J ;
Nandi, J ;
Ariffin, S ;
Jerstice, J ;
Danitsch, D ;
Levine, A .
ANNALS OF THORACIC SURGERY, 2006, 81 (05) :1767-1772
[3]   Incorporation of a computerized human patient simulator in critical care training: A preliminary report [J].
Hammond, J ;
Bermann, M ;
Chen, B ;
Kushins, L .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 2002, 53 (06) :1064-1067
[4]  
Hegarty MK., 2002, Current Anaesthesia Critical Care, V13, P194
[5]  
Hunt Elizabeth A, 2007, Anesthesiol Clin, V25, P301, DOI 10.1016/j.anclin.2007.03.004
[6]   A pilot study using high-fidelity simulation to formally evaluate performance in the resuscitation of critically ill patients: The University of Ottawa Critical Care Medicine, High-Fidelity Simulation, and Crisis Resource Management I Study [J].
Kim, John ;
Neilipovitz, David ;
Cardinal, Pierre ;
Chiu, Michelle ;
Clinch, Jennifer .
CRITICAL CARE MEDICINE, 2006, 34 (08) :2167-2174
[7]  
Lighthall Geoffrey K, 2007, J Intensive Care Med, V22, P257, DOI 10.1177/0885066607304273
[8]   Use of a fully simulated intensive care unit environment for critical event management training for internal medicine residents [J].
Lighthall, GK ;
Barr, J ;
Howard, SK ;
Gellar, E ;
Sowb, Y ;
Bertacini, E ;
Gaba, D .
CRITICAL CARE MEDICINE, 2003, 31 (10) :2437-2443
[9]   Six-year prospective audit of chest reopening after cardiac arrest [J].
Mackay, JH ;
Powell, SJ ;
Osgathorp, J ;
Rozario, CJ .
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 2002, 22 (03) :421-425
[10]   Survival to discharge following Open Chest Cardiac Compression (OCCC). A 4-year retrospective audit in a cardiothoracic specialist centre - Royal Brompton and Harefield NHS Trust, United Kingdom [J].
Pottle, A ;
Bullock, I ;
Thomas, J ;
Scott, L .
RESUSCITATION, 2002, 52 (03) :269-272