Interprofessional resuscitation rounds: a teamwork approach to ACLS education

Figures & data

Table

Practice points
•High fidelity medical simulation is a valuable learning tool.
•Interprofessional education should be encouraged and supported within medical training.
•Instruction in resuscitation skills should focus on hands-on, interactive, and interprofessional strategies.

Table 1.  Outline of Scenario Objectives

	Objectives & Roles
VFIB arrest	Assess unresponsiveness and manage initial ABCs
	Initiate CODE BLUE activation of team
	Start CPR, airway management, determine rhythm
	Immediate defibrillation
	Team leader to coordinate team tasks and decision making
ASYSTOLE	Assess unresponsiveness and manage initial ABCs
	Initiate CODE BLUE activation of team
	Start CPR, airway management, determine rhythm
	Initiate IV access/IV epinephrine, and confirm rhythm
	Team leader to coordinate team tasks and decision making
Unstable Bradycardia	Assess unresponsiveness and manage initial ABCs
	Initiate CODE BLUE activation of team
	Initate airway management and determine rhythm
	Initiate IV access/IV atropine
	Initiate cardiac pacing and confirm capture
	Team leader to coordinate team tasks and decision making
Pulseless VTAC	Assess unresponsiveness and manage initial ABCs
	Initiate CODE BLUE activation of team
	Start CPR, airway managemen and determine rhythm
	Immediate defibrillation
	Team leader to coordinate team tasks and decision making
VTAC with pulse	Assess unresponsiveness and manage initial ABCs
	Initiate CODE BLUE activation of team
	Initiate airway management and determine rhythm
	Immediate cardioversion and reassessment of rhythm
	Team leader to coordinate team tasks and decision making
PEA arrest	Assess unresponsiveness and manage initial ABCs
	Initiate CODE BLUE activation of team
	Start CPR, airway management, and determine rhythm
	Initiate IV access/IV epinephrine, and confirm rhythm
	Consider IV bicarb/atropine therapy
	Team leader to coordinate team tasks and decision making

Figure 1. Learner evaluation form.

Table 2.  Summary of study population

Total number of training sessions	20
Total number of students trained
Nursing students	101
Medical students	36
Residents	25
Total	144
Total number of evaluation forms (%)
Nursing students*	101 (45.4)
Medical students**	42 (18.9)
Residents**	79 (35.6)
Total	222 (100.0)
Average number of training sessions attended
Nursing students	1
Medical students	2
Residents	4

*Each nursing student was only able to attend one training session. **Medical students and residents were permitted to complete more than one evaluation form for a subsequent training session.

Table 3.  Summary of questionnaire scores

	Likert scores
Questionnaire Item	Mean	Range	Percentage = 4 or >
Interprofessional component valuable
Nursing students (n = 101)	4.85	3–5	99.0
Medical students (n = 42)	4.64	3–5	95.2
Residents (n = 79)	4.68	2–5	93.8
Total (n = 222)	4.75	2–5	96.4
Desire for further interprofessional sessions
Nursing students	4.79	3–5	99.0
Medical students	4.6	3–5	95.2
Residents	4.61	2–5	96.2
Total	4.69	2–5	97.3
Better understanding of team roles in resuscitation
Nursing students	4.76	3–5	99.0
Medical students	4.67	3–5	97.6
Residents	4.66	2–5	96.2
Total	4.71	2–5	97.7
Sessions should be mandatory
Nursing students	4.87	3–5	98.0
Medical students	4.71	3–5	95.2
Residents	4.84	3–5	98.7
Total	4.83	3–5	97.7
Simulation component valuable
Nursing students	4.89	4–5	100
Medical students	4.85	4–5	100
Residents	4.96	4–5	100
Total	4.91	4–5	100
Desire for further simulator–based sessions
Nursing students	4.82	3–5	98.0
Medical students	4.86	4–5	100
Residents	4.91	3–5	98.7
Total	4.86	3–5	98.6

Table 4.  Summary of written comments of learners

Please comment on the strengths of this exercise.
• Forces me to think through problems. Realistic team elements.
• Great to learn roles during codes using a collaborative, team-based approach.
• Great to practice team work. Hands-on experiences most valuable.
• Excellent teaching/leadership. Simulator mannequin was awesome.
• Non-threatening environment allows everyone to participate and make mistakes.
Please comment on areas for improvement.
• Not enough sessions for the nurses to practice.
• More simulator mannequins should be used so we can practice more.
• Medical simulation should be used more often in teaching.
• More teaching sessions.
• More practice with advanced airway skills and components of the crash cart.
Please comment on why you would or would not value additional inter-professional activities during your training.
• Inter-professional environment is more realistic and promotes better understanding of each other's roles.
• These sessions promote better communication skills and cooperation among health care professionals.
• This is a valuable experience that we previously hadn’t been exposed to in our training.