Competence and Confidence With Quality and Safety Education for Nurses Competencies by Newly Licensed Registered Nurses.

Understanding newly licensed registered nurses' perceived confidence in the Quality and Safety Education for Nurses (QSEN) competency domains and corresponding knowledge, skills, and attitudes will help inform clinical leaders to develop successful transition-to-practice programs. Newly licensed registered nurses and prelicensure nursing students had confidence in their understanding of QSEN competencies as they began their transition to practice. Online learning and virtual practicums were effective for attaining QSEN competencies, offering support for using these interventions in academic settings and transition-to-practice programs.

In situ medical simulation investigation of emergency department procedural sedation with randomized trial of experimental bedside clinical process guidance intervention.

Introduction: Patient safety during emergency department procedural sedation (EDPS) can be difficult to study. Investigators sought to delineate and experimentally assess EDPS performance and safety practices of senior-level emergency medicine residents through in situ simulation.

Methods: Study sessions used 2 pilot-tested EDPS scenarios with critical action checklists, institutional forms, embedded probes, and situational awareness questionnaires.

Simulation intervention with manikin-based objective metrics improves CPR instructor chest compression performance skills without improvement in chest compression assessment skills.

Introduction: Cardiopulmonary resuscitation (CPR) instructor/coordinator (CPR-I/C) adherence to published guidelines during resuscitation and learner assessment for basic life support (BLS)/CPR skills has not been experimentally studied. Investigators sought to (1) determine the quality of CPR-I/C chest compression and the accuracy of CPR-I/C chest compression assessment, and (2) improve CPR-I/C compression and assessment skills through cardiac arrest simulations with objective in-scenario performance feedback.

Methods: Thirty CPR-I/Cs (median, 20 years [range, 4-40 years] of BLS provider experience; 6 years [range 1-40 years] of BLS instructor experience) were randomized to control or experimental group.

Development of simulated chest compression videos for objective evaluation of CPR instructors.

The goal of the development phase of the CPR Instructor Real-time Review through Use of Simulation (CIRRUS) research program was to create a video library portraying a spectrum of objectively verified simulation chest compression performances. Investigators scripted and recorded 12 two-person cardiopulmonary resuscitation (CPR) videos with specific chest compression parameters encompassing a range of hand positions, rates, depths, and chest releases in combinations that proportionately reflected typical learner cohort performances. Six videos were designated to portray adequate chest compressions, whereas the other six videos were to feature inadequate compressions.

Pilot-phase findings from high-fidelity In Situ medical simulation investigation of emergency department procedural sedation.

Introduction: Emergency department procedural sedation (EDPS) is becoming widespread. Simulation may enhance patient safety through evidence-based training, effective assessment, and research of EDPS operators in pertinent knowledge, skills, processes, and teamwork.

Methods: Investigators developed a 2-scenario in situ simulation-based methodology and research tool kit for objective examination of EDPS practice.

In situ simulation comparing in-hospital first responder sudden cardiac arrest resuscitation using semiautomated defibrillators and automated external defibrillators.

Introduction: Multifaceted approaches using simulation and human factors methods may optimize in-hospital sudden cardiac arrest (SCA) response. The Arrhythmia Simulation/Cardiac Event Nursing Training-Automated External Defibrillator phase (ASCENT-AED) study used in situ medical simulation to compare traditional and AED-supplemented SCA first-responder models.

Methods: The study was conducted at an academic 719-bed hospital with institutional review board approval.

Comparison of sudden cardiac arrest resuscitation performance data obtained from in-hospital incident chart review and in situ high-fidelity medical simulation.

Introduction: High-fidelity medical simulation of sudden cardiac arrest (SCA) presents an opportunity for systematic probing of in-hospital resuscitation systems. Investigators developed and implemented the SimCode program to evaluate simulation's ability to generate meaningful data for system safety analysis and determine concordance of observed results with institutional quality data.

Methods: Resuscitation response performance data were collected during in situ SCA simulations on hospital medical floors.