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"Failure to rescue" - a quality indicator: can we do better?
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Weisneck, Teresa. "Failure to rescue" - a quality indicator: can we do better?. Retrieved from https://doi.org/doi:10.7282/t3-v9dd-b160

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Title"Failure to rescue" - a quality indicator: can we do better?
NameWeisneck, Teresa (author); Digiulio, Mary (chair); Rutgers University; RBHS School of Nursing
Date Created2022
Other Date2022-05 (degree)
SubjectNursing, Cardiac surgery, CVICU, Open chest, Resuscitation
Extent54 pages : illustrations
DescriptionPURPOSE
Initiate preparing the patient for an emergent sternal re-entry and gain chest re-entry within 5 minutes
METHODS
In November 2021, the pilot project was implemented in an Acute Care facility located in Southern New Jersey with participation from a total of 10 nightshift surgical ICU nurses. Development of this pilot project consisted of developing a mock “open” chest code based of the current policy at the facility and building a manikin to use for the simulation. The implementation took place over approximately three consecutive weekend nightshifts which consisted of mock “open” chest codes with simulation-based technology, a debriefing between the pre/post mock “open” chest code, and a post debriefing survey. Evaluation of the debriefing effectiveness was an anonymous survey which was handed into after the debriefing, pre/post mock “open” chest code times were recorded and analyzed to measure if there was a change in time before and after the debriefing.
RESULTS
There was a total of three groups that participated in the “mock” sternal re-entry codes with a total of 10 participants. There was no increase in times for any milestone for any group. The average decrease in time to chest re-entry was 129.7 ± 79.2 seconds. Due to the small sample size the results are limited. All times were decreased after the debriefing sessions. Utilization of simulation-based technology in the form of “mock” open chest codes improved efficiency in sternal re-entry. This was a pilot project, and a larger sample size would be recommended for further study.
Implications
Implementing the “mock” sternal re-entry codes with a debriefing in the cardiac surgical intensive care unit may reduce time to chest re-entry and decrease mortality rate among the patients in need of emergent sternal re-entry at the bedside by providing simulation-based learning for the inexperienced. This may also in turn lead to a decrease in patient cost of care, intensive care unit stay, and decrease cost for patient requiring emergent sternal re-entry.
KEYWORDS
“low frequency, high risk events,” mock code, sternal re-entry, cardiac surgery, resuscitation, debriefing
NoteD.N.P.
NoteIncludes bibliographical references
Genretheses
Persistent URLhttps://doi.org/doi:10.7282/t3-v9dd-b160
LanguageEnglish
CollectionSchool of Nursing (RBHS) DNP Projects
Organization NameRutgers, The State University of New Jersey
RightsThe author owns the copyright to this work.
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