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 OJEM  Vol.10 No.2 , June 2022
The Role of Structured Framework in Simulated Cardiac Emergency for Cardiothoracic Training
Abstract: Background: Both technical and nontechnical skills are important factors in cardiac emergency incident. The effects of structured framework on these skills have not been thoroughly studied. We hypothesized that structured framework can improve the clinical performance and reduce errors to improve patients’ safety. Methodology: A total of 24 teams composed of cardiac residents, attending surgeons and ICU nurses performed simulated emergency incident tasks in cardiopulmonary resuscitation (CPR) and tracheal intubation (TI) scenarios. Framework education was introduced to the assigned groups in two separate semesters. All the scenarios were recorded by video for further evaluation by cardiologist and emergency medicine specialist. Clinical performance, time consumption in simulated scenarios, correlation between framework training and nontechnical skills performance were assessed. Results: The average percentages of CPR completed in the Group 1 (G1) with framework education and the Group 2 (G2) were 85% (SEM: 6.20%) and 53% (SEM: 5.77%) respectively (P < 0.001). And the average percentages of TI completed in G2 with framework education was 87% (SEM: 3.96%), higher than G1 (50%, SEM: 5.64%) (P < 0.001). As for time consumption, the mean time to complete CPR in groups with framework education was shorter than in groups without framework education (P < 0.005). Similarly, the mean time to complete TI in groups with framework education was shorter than in groups without framework education (P < 0.005). Further, there was a significant correlation between framework training and communication in simulated scenarios. Conclusion: The framework provides the whole procedure of the task to every participant. Structured framework education can improve nontechnical skills as well as technical skills of doctors and nurses. Further, researches should be conducted to evaluate the clinical performance and correlation between technical skills and nontechnical skills in cardiothoracic training.
Cite this paper: Zhang, Y. , Lu, W. , Wang, J. , Shen, H. , Min, J. , Wang, Q. , Wang, J. and Wang, Z. (2022) The Role of Structured Framework in Simulated Cardiac Emergency for Cardiothoracic Training. Open Journal of Emergency Medicine, 10, 100-110. doi: 10.4236/ojem.2022.102009.
References

[1]   Gardner, A.K., Lachapelle, K., Pozner, C.N., et al. (2015) Expanding Simulation-Based Education through Institution-Wide Initiatives: A Blueprint for Success. Surgery, 158, 1403-1407. https://doi.org/10.1016/j.surg.2015.03.040

[2]   Raemer, D.B. (2009) Simulation in Cardiothoracic Surgery: A Paradigm Shift in Education? The Journal of Thoracic and Cardiovascular Surgery, 138, 1065-1066.
https://doi.org/10.1016/j.jtcvs.2009.07.056

[3]   Chitwood Jr., W.R., Spray, T.L., Feins, R.H., et al. (2008) Mission Critical: Thoracic Surgery Education Reform. The Journal of Thoracic and Cardiovascular Surgery, 136, 812-813. https://doi.org/10.1016/j.jtcvs.2008.08.012

[4]   Hauk, L. (2016) AHA Updates Guidelines for CPR and Emergency Cardiovascular Care. American Family Physician, 93, 791-797.

[5]   Kabrhel, C., Thomsen, T.W., Setnik, G.S., et al. (2007) Videos in Clinical Medicine. Orotracheal Intubation. The New England Journal of Medicine, 356, e15.
https://doi.org/10.1056/NEJMvcm063574

[6]   Cheskes, S., Schmicker, R.H., Christenson, J., et al. (2011) Perishock Pause: An Independent Predictor of Survival from Out-of-Hospital Shockable Cardiac Arrest. Circulation, 124, 58-66. https://doi.org/10.1161/CIRCULATIONAHA.110.010736

[7]   Meaney, P.A., Bobrow, B.J., Mancini, M.E., et al. (2013) Cardiopulmonary Resuscitation Quality: Improving Cardiac Resuscitation Outcomes Both Inside and Outside the Hospital: A Consensus Statement from the American Heart Association. Circulation, 128, 417-435. https://doi.org/10.1161/CIR.0b013e31829d8654

[8]   Finn Davis, K., Napolitano, N., Li, S., et al. (2017) Promoters and Barriers to Implementation of Tracheal Intubation Airway Safety Bundle: A Mixed-Method Analysis. Pediatric Critical Care Medicine: A Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 18, 965-972. https://doi.org/10.1097/PCC.0000000000001251

[9]   Grogan, E.L., Stiles, R.A., France, D.J., et al. (2004) The Impact of Aviation-Based Teamwork Training on the Attitudes of Health-Care Professionals. Journal of the American College of Surgeons, 199, 843-848.
https://doi.org/10.1016/j.jamcollsurg.2004.08.021

[10]   Reader, T.W., Flin, R., Mearns, K., et al. (2009) Developing a Team Performance Framework for the Intensive Care Unit. Critical Care Medicine, 37, 1787-1793.
https://doi.org/10.1097/CCM.0b013e31819f0451

[11]   Flowerdew, L., Brown, R., Vincent, C., et al. (2012) Identifying Nontechnical Skills Associated with Safety in the Emergency Department: A Scoping Review of the Literature. Annals of Emergency Medicine, 59, 386-394.
https://doi.org/10.1016/j.annemergmed.2011.11.021

[12]   Henneman, E.A., Blank, F.S., Gawlinski, A., et al. (2006) Strategies Used by Nurses to Recover Medical Errors in an Academic Emergency Department Setting. Applied Nursing Research, 19, 70-77. https://doi.org/10.1016/j.apnr.2005.05.006

[13]   Andersen, P.O., Maaloe, R. and Andersen, H.B. (2010) Critical Incidents Related to Cardiac Arrests Reported to the Danish Patient Safety Database. Resuscitation, 81, 312-316. https://doi.org/10.1016/j.resuscitation.2009.10.018

[14]   Kilroy, D.A. (2006) Clinical Supervision in the Emergency Department: A Critical Incident Study. Emergency Medicine Journal, 23, 105-108.
https://doi.org/10.1136/emj.2004.022913

[15]   Leape, L.L., Brennan, T.A., Laird, N., et al. (1991) The Nature of Adverse Events in Hospitalized Patients. Results of the Harvard Medical Practice Study II. The New England Journal of Medicine, 324, 377-384.
https://doi.org/10.1056/NEJM199102073240605

[16]   Probst, M.A., Noseworthy, P.A., Brito, J.P., et al. (2018) Shared Decision-Making as the Future of Emergency Cardiology. Canadian Journal of Cardiology, 34, 117-124.
https://doi.org/10.1016/j.cjca.2017.09.014

[17]   Brandling, J., Kirby, K., Black, S., et al. (2017) Emergency Medical Service Provider Decision-Making in out of Hospital Cardiac Arrest: An Exploratory Study. BMC Emergency Medicine, 17, Article No. 24. https://doi.org/10.1186/s12873-017-0136-3

[18]   Munroe, B., Curtis, K., Murphy, M., et al. (2016) A Structured Framework Improves Clinical Patient Assessment and Nontechnical Skills of Early Career Emergency Nurses: A Pre-Post Study Using Full Immersion Simulation. Journal of Clinical Nursing, 25, 2262-2274. https://doi.org/10.1111/jocn.13284

[19]   Steinemann, S., Berg, B., DiTullio, A., et al. (2012) Assessing Teamwork in the Trauma Bay: Introduction of a Modified “NOTECHS” Scale for Trauma. American Journal of Surgery, 203, 69-75. https://doi.org/10.1016/j.amjsurg.2011.08.004

 
 
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