The rhythm and blues project: A proposed method of skill and knowledge maintenance in Advanced Cardiac Life Support (ACLS) training and recertification

Julie C Humphries1, Mingshuang Ding1, Hansel Addae-Bosomprah1

1 Queen Elizabeth II Jubilee Hospital, Cnr Kessels Rd & Troughton Rd, Coopers Plains  QLD 4108 Australia

Background: The Queen Elizabeth II Jubilee (QEII) hospital is an urban district hospital with an Emergency Department (ED) which has 45,000 attendances per year.  QE II ED has a simulation training faculty which delivers simulation education and the Hospital’s ACLS training program.  Our current ACLS course is a one day certification course that consists of theoretical and practical components followed by a multiple choice test at the end.

The ED, however, has a high throughput of residents and registrars who rotate from periods of 5 weeks up to 6 months.  It is not always possible to put the entire mass through the competencies of ACLS during the term.  Retention of knowledge is ACLS a problem well recognised from various studies.

A method called ‘Rhythm and Blues’ is currently employed in QEII ED.  This aids residents who are unable to attend the full day course or who have not attended any courses, to be able to confidently participate in life support events related to patient care and training.  Residents who have already attended the course ACLS participate with the view of skill and knowledge retention.

Objective: To compare the outcomes of different groups of clinicians who receive proposed ACLS training to standard ACLS training method at QE II ED.

Method: This is a cohort studies.  ED / Medical Wards/ ICU doctors and nurses who respond to Code blues and RRT and have a requirement to undergo ACLS training as per Metro South.  Each participant will be randomly assigned (Pick a straw) to The Rhythm and Blues arm of the study or the Metro South ACLS certification pathway.

As a baseline all participants will undergo the 4 hour Metro South ACLS certification course which is valid for 12 months, they will be provided with full copies of the Metro South ACLS manual for ongoing reading and referencing for underpinning knowledge.

The Rhythm and Blues arm of the study group will undergo the rhythm and Blues pathway which consists of 10minutes per week of ACLS refreshers based on the training program.

A typical Rhythm and Blues session shall begin with a quick introduction to the learning objectives for the session.  The participant is given a scenario in a simulated environment using a patient training mannequin and patient data monitoring screen.  There shall initially be a case introduction and a running rhythm which will change to different rhythms as the scenario changes.  Participants will be drilled on four to five different rhythms and scenarios per session in rapid succession with each scenario transitioning to the next with limited interruption.  The drill is expected to last not more than 10minutes using a stop clock.  If a participant “flies” through the drills for a particular session the time taken to complete the drill will be noted.  Conversely the participant may move on to the next set of drills until the 10minute mark is completed.  In effect a participant who performs very well through the course of the drill may perform as many drills as possible within the 10 minute interval.

Expected Outcomes: At this stage a pilot study looking at short and long term skill and knowledge retention using our rhythm and blues drills compared to the full day course is being developed.

Biography

Mingshuang (Monica) Ding BMid;  MMidRes;  RM ;PhD Scholar Research Nurse/Midwife at the Emergency Department | QE II Jubilee Hospital AIA (Aeromedical Innovation Australasia) as a research Consultant Awarded academic title with Griffith University as a  Lecturer with in the School of Nursing and Midwifery.

Julie Humphries BNur; M(advance practice-emergency nursing); RNNurse Educator at the Emergency Department | QE II Jubilee Hospital.

Hansel Addae-BosomprahSenior Medical Officer at the Emergency Department | QE II Jubilee Hospital.