Abstract Body: Background: Deaths related to surgery are more likely in the postoperative period than during surgery itself with cardiac arrest occuring in up to 8% of post-op cardiac patients. However, resuscitation protocols for post-op coronary artery bypass graft (CABG) patients in the ICU require unique skills and actions, such as resternotomy & deviations from standard ACLS algorithms, that can contradict resuscitation practices for other patient populations. Self-efficacy of ICU staff can impact the timing and accuracy of resuscitation actions. Hesitations or incorrect actions can contribute to poor outcomes.
Purpose: Booster training in the ICU involving standard equipment and protocols for the resuscitation of post-op CABG patients can allow ICU staff to master complex technical skills safely. This QI project evaluated the effect of booster training on confidence in ICU physicians and nurses.
Clinical Question: How does CABG policy booster training impact confidence in ICU staff caring for post-op CABG patients?
Methodology & Design: This project used quantitative methodology and quasi-experimental design. Convenience sampling of ICU nurses and physicians was utilized at a local teaching hospital. The C-Scale was the validated tool for measuring self-efficacy in ICU RNs and resident physicians. Training included ICU RNs, Internal Medicine, and Surgical residents. Sessions involved tools required for resternotomy and practiced simulations to identify deviations from traditional ACLS algorithms.
Data Analysis: Paired Two Sample t-Test in Excel was used to analyze improvement in self-efficacy scores from pre-and post-training surveys with a statistical significance (p = < .05).
Sample: Convenience sampling included ICU RNs, IM & Surgical residents (N = 82).
Results: The t-Test results validate that self-confidence was statistically improved: t(81) = -17.556, p < .001.
Implications: Improved confidence (self-efficacy), has been linked to increased speed and accuracy in actions, which is crucial in resuscitation where seconds count. Booster training for ICU staff caring for post-op CABG patients can significantly enhance self-efficacy with the complex and unique protocols and skills required for the resuscitation of this patient population. The project results indicate that booster training simulations should be considered for ICU nurses and physicians who care for postoperative CABG patients.
Keywords: CABG, booster training, self-efficacy, resuscitation, resternotomy, ACLS