Simulation can improve time to first shock for in-hospital cardiac arrest
An online education and code simulation intervention can improve adherence to the guidelines for time to first shock in patients with in-hospital cardiac arrest, according to a study published in the December issue of Critical Care Nurse.
Andrea Paddock, from Orlando Health Dr. P. Phillips Hospital in Florida, developed nurse simulation education and training to standardize intensive care unit code processes and improve compliance with timely defibrillation. A sample of intensive care unit nurses was assigned online education, including electrocardiogram recognition and code documentation. Nurses and physicians collaborated to develop a diagram with the roles needed for successful conduct of a code situation; a video was created to reflect these roles and was embedded in the online education. Structured code simulations were completed by intensive care nurses, allowing them to practice being the leader. A survey was distributed to nurses three months after the intervention.
The researchers found a 100 percent decrease in the time-to-first-shock fallouts in the intensive care unit and a 71 percent decrease in the facility’s fallouts. There was an increase from 42 to 83 percent in the facility’s adherence to the time-to-first-shock metric. Eighty-nine percent of nurses reported perceived improvement in knowledge, team leadership and communication, and confidence associated with code events in a postintervention survey.
“A presimulation discussion and slow code walk-through were crucial elements to equipping participants with the knowledge to respond more appropriately during the simulation and translate that knowledge into practice,” Paddock said in a statement.