Transcript Provider Course

Hypothesis
Our next hypothesis:
After a 2 year hiatus, does resuscitation skill
performance and HFHS trained individuals
improve to a greater percentage than
traditionally trained didactic only
individuals following a didactic only
refresher if the team is physician led?
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Methods
n= 234
Twenty-six teams of 9
Subjects were selected from students
coming in randomly for ACLS Refresher
training.
Teams were formed based on their
exposure to HFHS or not.
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Methods
Previous returning students who had
obviously been exposed to HFHS were
assigned to the HFHS teams.
Subjects who were assigned to the
traditional group were based on a review
of our records which showed they had not
attended any of our courses, not even
Health Care Provider CPR with our
simulators.
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Methods
Our database (Training Manager)
randomizes the names. We have no
control of how the students name appear
on the roster or in the order in which they
appear. It does not alphabetize. When a
course roster is printed, team leaders
were selected from the top of the list.
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Methods
The next step was to find a Respiratory
Therapist or Anesthesiologist to fill the
Advanced Airway position, and lastly, all
nurses filled team member positions,
from the top of the list, down.
The investigators were blinded, having no
knowledge of which team was being
observed.
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Methods
As the subjects arrived they received
their team badge and written code
room instructions and student survey.
Once they were all seated, our
administrative assistant would select
which team came into the learning lab
first.
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Methods
Once assembled, the team received
oral instructions which were read
from a prepared paper about what the
HFHS could do as well as the
defibrillator and medications available
in the crash cart. Recording sheets
and AHA crash cart cards were
available for each simulation.
7
Methods
Each simulation scenario lasted ten
minutes.
Each team received the same
scenario of a patient in V-fib cardiac
arrest.
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Methods
3 measurements were taken:
First V-fib resuscitation of the simulator
before any training was received.
Second, following a 4 hour lecture
covering the AHA Guidelines and
practicing High-quality CPR and
using an AED
9
Methods
Finally, Last V-fib resuscitation of the
training day.
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Methods
Team leadership and individual skills
were evaluated using video tape and
SimMan event logs printed for each
of the resuscitations.
Time to task completion was marked
for each task using the AHA
Guideline Model.
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Methods
We constructed an AHA Guidelines model which
looked at specific tasks and time to completion.
Start CPR
Defib #1
CPR
Defib #2
CPR
Epinephrine #1
Defib #3
CPR
Amiodarone
Epinephrine #2
Defib #4
CPR
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Results
The level of
compliance of
treating a HFHS in
V-fib in compliance
with the AHA
Guidelines following
a 2 year hiatus
before any training
was the same for
both groups, less
than 30%.
Poster Presentation RESS 2010
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Results
Following a 4 hour lecture covering the
AHA Guidelines and practicing Highquality CPR and using an AED.
The level of compliance of treating a
HFHS in V-fib increased to 55% as
compared to the traditional trained
group which was at 40%.
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Results
Following a 4 hour lecture covering the
AHA Guidelines and practicing Highquality CPR and using an AED, and
practice codes.
The level of compliance of treating a
HFHS in V-fib increased to 75% as
compared to the traditional trained
group which was at 60%.
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Conclusion
Following a 2 year hiatus in ACLS training,
there appears to be a significant
degradation of skills and knowledge to a
level that may be insufficient for effective
resuscitation, regardless of the training
modality.
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