| 1. |
- Allvin, Renée, 1956-, et al.
(författare)
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Confident but not theoretically grounded : experienced simulation educators’ perceptions of their own professional development
- 2017
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Ingår i: Advances in Medical Education and Practice. - Macclesfield : DOVE Medical Press Ltd.. - 1179-7258. ; :8, s. 99-108
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Tidskriftsartikel (refereegranskat)abstract
- Background: Medical simulation enables the design of learning activities for competency areas (eg, communication and leadership) identi ed as crucial for future health care professionals. Simulation educators and medical teachers follow different career paths, and their education backgrounds and teaching contexts may be very different in a simulation setting. Although they have a key role in facilitating learning, information on the continuing professional development (pedagogical development) of simulation educators is not available in the literature. Objectives: To explore changes in experienced simulation educators’ perceptions of their own teaching skills, practices, and understanding of teaching over time.Methods: A qualitative exploratory study. Fourteen experienced simulation educators partici- pated in individual open-ended interviews focusing on their development as simulation educators. Data were analyzed using an inductive thematic analysis. Results: Marked educator development was discerned over time, expressed mainly in an altered way of thinking and acting. Five themes were identi ed: shifting focus, from following to utilizing a structure, setting goals, application of technology, and alignment with profession. Being con dent in the role as an instructor seemed to constitute a foundation for the instructor’s pedagogical development.Conclusion: Experienced simulation educators’ pedagogical development was based on self- con dence in the educator role, and not on a deeper theoretical understanding of teaching and learning. This is the rst clue to gain increased understanding regarding educational level and possible education needs among simulation educators, and it might generate several lines of research for further studies.
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| 2. |
- Hessulf, Fredrik, 1986, et al.
(författare)
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Adherence to Guidelines is Associated With Improved Survival Following In-hospital Cardiac Arrest in Sweden
- 2020
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Ingår i: Resuscitation. - : Lippincott Williams & Wilkins. - 0300-9572 .- 1873-1570. ; 155, s. -21
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Tidskriftsartikel (refereegranskat)abstract
- Background: Most resuscitation guidelines have recommendations regarding maximum delay times from collapse to calling for the rescue team and initiation of treatment following cardiac arrest. The aim of the study was to investigate the association between adherence to guidelines for cardiopulmonary resuscitation (CPR) after in-hospital cardiac arrest (IHCA) and survival with a focus on delay to treatment.Methods: We used the Swedish Registry for CPR to study 3212 patients with a shockable rhythm and 9113 patients with non-shockable rhythm from January 1, 2008 to December 31, 2017. Adult patients older than or equal to 18 years with a witnessed IHCA where resuscitation was initiated were included. We assessed trends in adherence to guidelines and their associations with 30-day survival and neurological function. Adherence to guidelines was defined as follows: time from collapse to calling for the rescue team and CPR within 1 min for non-shockable rhythms. For shockable rhythms, adherence was defined as the time from collapse to calling for the rescue team and CPR within 1 min and defibrillation within 3 min.Results: In patients with a shockable rhythm, the 30-day survival for those treated according to guidelines was 66.1%, as compared to 46.5% among those not treated according to guidelines on one or more parameters, adjusted odds ratio 1.84 (95% CI 1.52-2.22). Among patients with a non-shockable rhythm the 30-day survival for those treated according to guidelines was 22.8%, as compared to 16.0% among those not treated according to guidelines on one or more parameters, adjusted odds ratio 1.43 (95% CI 1.24-1.65). Neurological function (cerebral performance category 1-2) among survivors was better among patients treated in accordance with guidelines for both shockable (95.7% vs 91.1%, <0.001) and non-shockable rhythms (91.0% vs 85.5%, p < 0.008). Adherence to the Swedish guidelines for CPR increased slightly 2008-2017.Conclusions: Adherence to guidelines was associated with increased probability of survival and improved neurological function in patients with a shockable and non-shockable rhythm, respectively. Increased adherence to guidelines could increase cardiac arrest survival.
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| 3. |
- Hessulf, Fredrik, 1986, et al.
(författare)
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Factors of importance to 30-day survival after in-hospital cardiac arrest in Sweden - A population-based register study of more than 18,000 cases.
- 2017
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Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754.
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND OBJECTIVE: In-hospital cardiac arrest (IHCA) constitutes a major contributor to cardiovascular mortality. The aim of the present study was to investigate factors of importance to 30-day survival after IHCA in Sweden.METHODS: A retrospective register study based on the Swedish Register of Cardiopulmonary Resuscitation (SRCPR) 2006-2015. Sixty-six of 73 hospitals in Sweden participated. The inclusion criterion was a confirmed cardiac arrest in which resuscitation was attempted among patients aged >18years.RESULTS: In all, 18,069 patients were included, 39% of whom were women. The median age was 75years. Thirty-day survival was 28.3%, 93% with a CPC score of 1-2. One-year survival was 25.0%. Overall IHCA incidence in Sweden was 1.7 per 1000 hospital admissions. Several factors were found to be associated with 30-day survival in a multivariable analysis. They included cardiac arrest (CA) at working days during the daytime (08-20) compared with weekends and night-time (20-08) (OR 1.51 95% CI 1.39-1.64), monitored CA (OR 2.18 95% CI 1.99-2.38), witnessed CA (OR 2.87 95% CI 2.48-3.32) and if the first recorded rhythm was ventricular fibrillation/tachycardia, especially in combination with myocardial ischemia/infarction as the assumed aetiology of the CA (OR for interaction 4.40 95% CI 3.54-5.46).CONCLUSION: 30-day survival after IHCA is associated with the time of the event, the aetiology of the CA and the degree of monitoring and this should influence decisions regarding the appropriate level of monitoring and care.
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| 6. |
- Källestedt, Marie-Louise Södersved, et al.
(författare)
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Occupational affiliation does not influence practical skills in cardiopulmonary resuscitation for in-hospital healthcare professionals
- 2011
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Ingår i: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. - : Springer Science and Business Media LLC. - 1757-7241. ; 19, s. 3-
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Tidskriftsartikel (refereegranskat)abstract
- Background: D-CPR (Defibrillator Cardiopulmonary Resuscitation) is a technique for optimal basic life support during cardiopulmonary resuscitation (CPR). Guidelines recommend that healthcare professionals can perform CPR with competence. How CPR training and provision is organized varies between hospitals, and it is our impression that in Sweden this has generally improved during the last 15-20 years. However, some hospitals still do not have any AED (Automated External Defibrillators). The aim was to investigate potential differences in practical skills between different healthcare professions before and after training in D-CPR. Methods: Seventy-four healthcare professionals were video recorded and evaluated for adherence to a modified Cardiff Score. A Laerdal Resusci Anne manikin in connection to PC Skill reporting System was used to evaluate CPR quality. A simulated CPR situation was accomplished during a 5-10 min scenario of ventricular fibrillation. Paired and unpaired statistical methods were used to examine differences within and between occupations with respect to the intervention. Results: There were no differences in skills among the different healthcare professions, except for compressions per minute. In total, the number of compression per minute and depth improved for all groups (P < 0.001). In total, 41% of the participants used AED before and 96% of the participants used AED after the intervention (P < 0.001). Before intervention, it took a median time of 120 seconds until the AED was used; after the intervention, it took 82 seconds. Conclusion: Nearly all healthcare professionals learned to use the AED. There were no differences in CPR skill performances among the different healthcare professionals.
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| 7. |
- Silverplats, Jennie, et al.
(författare)
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Compliance with cardiopulmonary resuscitation guidelines in witnessed in-hospital cardiac arrest events and patient outcome on monitored versus non-monitored wards
- 2024
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Ingår i: Resuscitation. - : Elsevier. - 0300-9572 .- 1873-1570. ; 196
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundAdherence to cardiopulmonary resuscitation (CPR) guidelines in treatment of in-hospital cardiac arrest (IHCA) have been associated with favourable patient outcome. The aim of this study was to evaluate if compliance with initial CPR guidelines and patient outcome of witnessed IHCA events were associated with the place of arrest defined as monitored versus non-monitored ward.MethodsA total of 956 witnessed IHCA events in adult patients at six hospitals during 2018 to 2019, were extracted from the Swedish Registry of Cardiopulmonary Resuscitation. Initial CPR guidelines were: ≤1 min from collapse to alert of the rapid response team, ≤1 min from collapse to start of CPR, ≤3 min from collapse to defibrillation of shockable rhythm.ResultsThe odds of compliance with guidelines was higher on monitored wards vs non-monitored wards, even after adjustment for factors that could affect staffing and resources. The place of arrest was not a significant factor for sustained return of spontaneous circulation, survival at 30 days, or neurological status at discharge, when adjusting for clinically relevant confounders. Compliance with initial CPR guidelines remained a significant factor for survival to 30 days and favourable neurological outcome at discharge regardless of other confounders.ConclusionCompliance with initial CPR guidelines was higher in witnessed IHCA events on monitored wards than on non-monitored wards, which indicates that healthcare professionals in monitored wards are quicker to recognize a cardiac arrest and initiate treatment. When initial CPR guidelines are followed, the place of arrest does not influence patient outcome.
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| 8. |
- Silverplats, Jennie
(författare)
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In-hospital cardiac arrest and cardiopulmonary resuscitation in Sweden : Healthcare professionals’ competence and compliance with guidelines
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Competence in cardiopulmonary resuscitation (CPR) is the foundation for performing CPR in accordance with guidelines during in-hospital cardiac arrest (IHCA) events, which is crucial to patient survival. All IHCA events are to be reported to the Swedish Registry of Cardiopulmonary Resuscitation (SRCR), but compliance is unclear. This may affect the interpretation of patient characteristics, IHCA care and outcomes.The aim of this thesis was to evaluate CPR competence and compliance with guidelines among in-hospital healthcare professionals (HCP), including evaluation of possible associated factors, patient characteristics, situational factors, and patient outcomes in the in-hospital setting.Methods: Data were collected through surveys among in-hospital HCPs during 2009 and 2013–2016. Further, data from the SRCR, the Swedish PeriOperative Register, and medical records were used to find all treated IHCA events at selected hospitals during 2018–2019. All witnessed IHCA events involving adult patients were evaluated regarding compliance with initial CPR guidelines.Results: The theoretical knowledge of CPR was poor and self-assessed abilities of performing CPR were low. Recent CPR training, working on a monitored ward, and being a nurse or physician were factors associated with higher knowledge and ratings of abilities. A majority of HCPs showed positive attitudes towards being required to perform CPR. However, attitudes in real-life IHCA situations signaled a possible perceived lack of resources. The case completeness of IHCA events in the SRCR was lacking. Most non-reported events occurred on monitored wards, with differences from reported events observed. Compliance with initial CPR guidelines was higher among HCPs on monitored wards versus non-monitored wards, but the place of arrest was not associated with patient outcome.Conclusion: The results underline the importance of frequent CPR training, especially on non-monitored wards, and of compliance with initial CPR guidelines. Non-reporting of IHCA events on monitored wards affects the interpretation of patient characteristics, IHCA care and outcomes. The procedures for reporting IHCA to the SRCR need to be well established. Reviews of patient medical records from monitored wards may improve case completeness in the SRCR.
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| 9. |
- Silverplats, Jennie, et al.
(författare)
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Theoretical knowledge and self-assessed ability to perform cardiopulmonary resuscitation : a survey among 3044 healthcare professionals in Sweden
- 2020
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Ingår i: European journal of emergency medicine. - : LIPPINCOTT WILLIAMS & WILKINS. - 0969-9546 .- 1473-5695. ; 27:5, s. 368-372
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Tidskriftsartikel (refereegranskat)abstract
- Objective Theoretical knowledge and ability to perform cardiopulmonary resuscitation (CPR) are unknown with regard to provided training. The aim of this study was to evaluate in-hospital healthcare professionals’ (HCPs) theoretical knowledge of CPR and their self-assessed ability to perform CPR and also to assess possible affecting factors. Method A questionnaire was sent to n = 5323 HCPs containing a nine-question knowledge test and a Likert scale measuring self-assessed ability. A factor score of self-assessed ability and a ratio scale of correct answers were dependent variables in multiple linear regression. Results Only 41% of the responding HCPs passed the knowledge test with seven or more correct answers. Nurses had the highest pass rate (50%) and the highest attendance rate at CPR training (56%). The ability to perform defibrillation was strongly agreed by 43% and the ability of leadership by only 7%. Working on a monitored ward, CPR training 0–6 months ago and being a nurse or physician were factors associated with more correct answers and higher ratings of abilities. Conclusion The overall theoretical knowledge was poor and ratings of self-assessed abilities to perform CPR were low. Working on a monitored ward, recently attended CPR training and being a nurse or physician were factors associated with higher theoretical knowledge and higher ratings of self-assessed ability to perform CPR. These findings imply prioritisation of CPR training.
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| 10. |
- Strömsöe, Anneli, 1969-, et al.
(författare)
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Improvements in logistics could increase survival after out-of-hospital cardiac arrest in Sweden
- 2013
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Ingår i: Journal of Internal Medicine. - : Wiley. - 0954-6820 .- 1365-2796. ; 273:6, s. 622-627
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. In a review based on estimations and assumptions, to report the estimated number of survivors after out-of-hospital cardiac arrest (OHCA) in whom cardiopulmonary resuscitation (CPR) was started and to speculate about possible future improvements in Sweden.Design. An observational study. Setting All ambulance organisations in Sweden. Subjects Patients included in the Swedish Cardiac Arrest Registry who suffered an OHCA between January 1, 2008 and December 31, 2010. Approximately 80% of OHCA cases in Sweden in which CPR was started are included. Interventions NoneResults. In 11005 patients, the 1-month survival rate was 9.4%. There are approximately 5000 OHCA cases annually in which CPR is started and 30-day survival is achieved in up to 500 patients yearly (6 per 100000 inhabitants). Based on findings on survival in relation to the time to calling for the Emergency Medical Service (EMS) and the start of CPR and defibrillation, it was estimated that, if the delay from collapse to (i) calling EMS, (ii) the start of CPR, and (iii) the time to defibrillation were reduced to <2min, <2min, and <8min, respectively, 300400 additional lives could be saved.Conclusion. Based on findings relating to the delay to calling for the EMS and the start of CPR and defibrillation, we speculate that 300400 additional OHCA patients yearly (4 per 100000 inhabitants) could be saved in Sweden.
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