“Rolling Refreshers”: A novel approach to maintain CPR psychomotor skill competence |
| |
| Authors: | Dana Niles Robert M Sutton Aaron Donoghue Mandip S Kalsi Kathryn Roberts Lori Boyle Akira Nishisaki Kristy B Arbogast Mark Helfaer Vinay Nadkarni |
| |
| Institution: | 1. Center for Simulation, Advanced Education and Innovation, The Children''s Hospital of Philadelphia, 34th Street and Civic Center Blvd., Philadelphia, PA 19104, United States;2. Department of Anesthesiology, Critical Care and Pediatrics, The Children''s Hospital of Philadelphia, University of Pennsylvania School of Medicine, 34th Street and Civic Center Blvd., Philadelphia, PA 19104, United States;3. Department of Anesthesiology, Thomas Jefferson University Hospital, 111 South 11th Street, Philadelphia, PA 19107, United States;4. Department of Nursing, The Children''s Hospital of Philadelphia, University of Pennsylvania School of Medicine, 34th Street and Civic Center Blvd., Philadelphia, PA 19104, United States;5. The Center for Injury Prevention and Research, The Children''s Hospital of Philadelphia, 3535 Market Street, Philadelphia, PA 19104, United States;1. Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, South Korea;2. Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, South Korea;3. Department of Emergency Medicine, Dongkuk University Ilsan Hospital;4. Department of Emergency Medicine, Kyoungpook National University Hospital;5. Department of Emergency Medicine, Singapore General Hospital, and Health Services and Systems Research, Duke-NUS Graduate Medical School, Singapore;6. Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA;7. Bureau of EMS and Trauma System, Arizona State Department of Health Service, Phoenix, AZ;8. Department of Emergency Medical System, Kokushikan University, Tokyo, Japan;9. Laerdal Medical, Stavanger, Norway;1. Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea;2. Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, South Korea;3. Department of Emergency Medicine, Hallym University, School of Medicine, Seoul, South Korea;4. Department of Emergency Medicine, Gachon University School of Medicine and Science, Incheon, South Korea;5. Division of Cardiology, Department of Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea;1. Department of Emergency Medicine, Center for Resuscitation Science, University of Pennsylvania, Philadelphia, PA, United States;2. Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA, United States;3. Department of Medicine, University of Chicago, Chicago, IL, United States;4. Advanced Algorithm Research Center, Philips Healthcare, Andover, MA, United States;5. Department of Emergency Medicine, University of Texas Southwestern Medical Center, Dallas, TX, United States;6. Department of Emergency Medicine, Oregon Health & Science University, Portland, OR, United States;1. University of Toronto, Toronto, ON, Canada;2. University of Washington, Seattle, WA, United States;3. University of British Columbia, Vancouver, BC, Canada;4. University of Ottawa, Ottawa, ON, Canada;5. Oregon Health and Science University, Portland, OR, United States;6. University of California/San Diego, San Diego, CA, United States;7. St. Paul''s Hospital, Vancouver, BC, Canada;1. Institute of Clinical Medicine, University of Oslo, P.O. Box 1171 Blindern, N-0318 Oslo, Norway;2. Norwegian National Advisory Unit on Prehospital Emergency Medicine (NAKOS), Oslo University Hospital, P.O. Box 4956 Nydalen, N-0424 Oslo, Norway;3. Department of Anaesthesiology, Oslo University Hospital and University of Oslo, P.O. Box 4956 Nydalen, N-0424 Oslo, Norway;4. Laerdal Medical AS, Tanke Svilandsgate 30, N-4002 Stavanger, Norway;5. Prehospital Clinic, Oslo University Hospital, P.O. Box 4956 Nydalen, N-0424 Oslo, Norway;1. Norwegian Center for Prehospital Emergency Care, Oslo University Hospital, Oslo, Norway;2. Institute of Clinical Medicine, University of Oslo, Oslo, Norway;3. Houston Fire Department and the Baylor College of Medicine, Houston, TX, United States;4. Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria;5. Hillsborough County Fire Rescue, Tampa, FL, United States;6. Department of Emergency Medicine, Lake Erie College, Bradenton, FL, United States;7. Heart Lung Center, Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands;8. Gold Cross Ambulance Service, Appleton Neenah-Menasha and Grand Chute Fire Departments, WI, United States;9. Theda Clark Regional Medical Center, Neenah, WI, United States;10. Wiener Rettung, Municipal ambulance service of Vienna, Vienna, Austria;11. Regional Ambulance Service Gelderland-Zuid, Nijmegen, The Netherlands;12. Medical and Pharmaceutical Statistics Research Unit, Department of Mathematics and Statistics, Fylde College, Lancaster University, Lancaster, United Kingdom;13. ZOLL Medical Corporation, Chelmsford, MA, United States;14. Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee, WI, United States |
| |
| Abstract: | ObjectivesHigh quality CPR skill retention is poor. We hypothesized that “just-in-time” and “just-in-place” training programs would be effective and well-accepted to maintain CPR skills among PICU staff.Methods“Rolling Refreshers”, a portable manikin/defibrillator system with chest compression sensor providing automated corrective feedback to optimize CPR skills, were conducted daily in the PICU with multidisciplinary healthcare providers. Providers practiced CPR until skill success was attained, prospectively defined as <3 corrective prompts within 30 s targeting chest compression (CC) rate 90–120/min, CC depth >38 mm during continuous CPR. Providers completing ≥2 refreshers/month (Frequent Refreshers FR]) were compared to providers completing <2 refreshers/month (Infrequent Refreshers IR]) for time to achieve CPR skill success. Univariate analysis performed using non-parametric methods. Following actual cardiac arrests, CPR providers were surveyed for subjective feedback on training approach efficacy (5-point Likert scale; 1 = poor to 5 = excellent).ResultsOver 15 weeks, 420 PICU staff were “refreshed”: 340 nurses, 34 physicians, 46 respiratory therapists. A consecutive sample of 20 PICU staff was assessed before subsequent refresher sessions (FREQ n = 10, INFREQ n = 10). Time to achieve CPR skill success was significantly less in FREQ (median 21 s, IQR: 15.75–30 s) than in INFREQ (median 67 s, IQR: 41.5–84 s; p < 0.001). Following actual resuscitations, CPR providers (n = 9) rated “Rolling Refresher” training as effective (mean = 4.2; Likert scale 1–5; standard deviation 0.67).ConclusionsA novel “Rolling Refresher” CPR skill training approach using “just-in-time” and “just-in-place” simulation is effective and well received by PICU staff. More frequent refreshers resulted in significantly shorter times to achieve proficient CPR skills. |
| |
| Keywords: | |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
