Increasing the Accuracy of Extracorporeal Membrane Oxygenation Critical Event Management in the Medical Intensive Care Unit.

Background & Problems: Extracorporeal membrane oxygenation (ECMO) is an intervention that replaces cardiopulmonary function temporarily to reduce injury to vital organs. As important members of the ECMO medical team, intensive care unit nurses must be well trained and alert to possible critical events. Failure to troubleshoot and manage ECMO promptly and correctly significantly increases the risk of mortality. A previous ECMO critical event in our unit resulted in lingering concerns and stress among nurses related to implementing this intervention. A survey conducted among our medical intensive care unit (MICU) nurses identified an implementation accuracy level for ECMO critical event management of only 59.1%. This poor result was attributed to a lack of technical assessment standards, in-service training, clinical experience, and instruction materials and the failure to offer online courses. Purpose: This study was designed to increase the accuracy of ECMO critical event management implementation among intensive care unit nurses to > 86%. Resolutions: We conducted a problem-based training project to improve ECMO critical event management that: introduced a technical assessment sheet and technical simulation exercise, organized in-service training, implemented irregular simulation exercises, and produced multiple different instructional materials. Result: The accuracy of ECMO critical event management implementation among the intensive care unit nurses increased from 59.1% pretest to 95.9% posttest. Conclusion: This project improved the ECMO care ability of MICU nurses in our hospital significantly, resulting in increased ECMO critical event management implementation accuracy, better patient care, higher nursing staff confidence, and lower perceived stress among nursing staff. [ABSTRACT FROM AUTHOR]