Improving Time to Defibrillation Following Ventricular Tachycardia (VTach) and Ventricular Fibrillation (VFib) Cardiac Arrest: A Multicenter Retrospective and Prospective Quality Improvement Study.

The goal of this study was to identify how often 2 independent centers defibrillated patients within the American Heart Association recommended 2-minute time interval following ventricular fibrillation/ventricular tachycardia arrest. A retrospective chart review revealed significant delays in defibrillation. Simulation sessions and modules were implemented to train nursing staff in a single nursing unit at a Philadelphia teaching hospital. Recruited nurses completed a code blue simulation session to establish a baseline time to defibrillation. They were then given 2 weeks to complete an online educational module. Upon completion, they participated in a second set of simulation sessions to assess improvement. First round simulations resulted in 33% with delayed defibrillation and 27% no defibrillation. Following the module, 77% of the second round of simulations ended in timely defibrillation, a statistically significant improvement ( P < 0.00001). Next steps involve prospective collection of the code blue data to analyze improvement in real code blue events.

Left ventricular assist device driveline infection and the frequency of dressing change in hospitalized patients.

OBJECTIVES: To determine if driveline infection is related to dressing change frequency in hospitalized adult patients with newly implanted left ventricular assist devices (LVAD). BACKGROUND: Guidelines do not exist for the frequency of driveline exit-site dressing change in hospitalized patients resulting in wide variation in practice. METHODS: A retrospective chart review was conducted on 68 patients implanted with a HeartMate II LVAD between August 2008 and September 2013 at an urban medical center. RESULTS: No driveline infections were found. Frequency of the driveline dressing change varied from daily, three times a week, and weekly. The daily dressing change group was younger in age compared to the weekly group (p = 0.005) and three times a week group (p = 0.001). No other differences were found. CONCLUSION: Driveline infections do not appear to be related to the frequency of dressing change in this population. Our data and other studies on this topic thus far are too limited to draw definitive conclusions about optimal frequency of dressing change for infection prevention.

The transition of a classroom dysrhythmia course to e-learning.

Technological advances and the global economy in the 21st century have shifted the traditional practices in adult education and lifelong learning in healthcare organizations. Thomas Jefferson University Hospital changed its traditional 2-day nursing classroom dysrhythmia course to an e-learning platform. The role of the clinical nurse specialist in the planning and implementation of this case is presented. Nursing staff development and the clinical nurse specialists proved to be driving forces for the transformation of the course, reinforcement of learning, and promotion of future educational technology.