Training of Nurses and Continuing Education in ECMO

Priest, Marc; Beaty, Chris; Ogino, Mieko

doi:10.1007/978-3-319-20101-6_12

Cited by 4 publications

(5 citation statements)

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“…According to the ELSO guidelines, treatment of ECMO-SPs should use a single-caregiver model, with a ratio of 1 RN to 1 patient. 10 In contrast, Priest et al 11 and Johnson 12 discussed a 2:1 model, with 1 RN in charge of treating the patient and 1 ECMO technician (nurse or perfusionist) looking after the ECMO machinery and circuit. According to the recommendations of the New Zealand Ministry of Health, caring for each ECMO-SP requires 2 RNs, 1 for the patient and 1 for the ECMO circuit, in the absence of a perfusionist.…”

Section: Determining Boundaries Of Rns' Professional Authority and Responsibilitymentioning

confidence: 99%

“…13 Similarly, there is no agreement regarding the responsibilities of RNs on ECMO teams. According to Priest et al, 11 an RN on the ECMO team is primarily responsible for treating the patient and not for managing the ECMO device. However, the responsibilities of the RN may also include blood circulation testing (assessing the circuit tubing for blood clots and air bubbles) and fluid delivery, depending on the patient's hemodynamic state and whether the situation is an emergency.…”

Section: Determining Boundaries Of Rns' Professional Authority and Responsibilitymentioning

confidence: 99%

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Recommendations From the Professional Advisory Committee on Nursing Practice in the Care of ECMO–Supported Patients

Melnikov

Furmanov

Gololobov

et al. 2021

Critical Care Nurse

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Background By July 2020, the Extracorporeal Life Support Organization had documented more than 133 000 extracorporeal membrane oxygenation (ECMO) implementations, with more than 61 000 implementations in adult patients. No clear policies regarding the authority and responsibility of nursing staff in the treatment of ECMO-supported patients are currently available. Objective To formulate evidence-based recommendations for nursing care of ECMO-supported patients. Methods The National Head Nurse’s office and the Professional Guidelines Department in the Nursing Division of Israel’s Ministry of Health formed the Professional Advisory Committee on Nursing Practice in the Care of ECMO-Supported Patients to address concerns regarding the current state of professional nursing practice in the care of these patients. The Professional Advisory Committee brought together 15 senior Israeli ECMO nursing experts who explored the potential of registered nurses in caring for ECMO-supported patients, considered the competencies of nurses treating ECMO-supported patients, discussed training programs and health care policy, and examined nursing outcomes for quality assurance. Results The Professional Advisory Committee formulated recommendations regarding the following priority issues: (1) determining boundaries of professional authority and nurses’ responsibilities, including designated activities for different professional ranks of registered nurses; (2) providing appropriate content for the training programs offered, such as generic/basic, above-basic, and clinical specialization nursing programs; and (3) defining relevant quality measures for nursing treatment of ECMO-supported patients. Conclusions Introducing international standards would ensure the safety and effectiveness of nursing care for ECMO-supported patients through quality and risk management and establishment of new evidence-based nursing practices.

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Section: Determining Boundaries Of Rns' Professional Authority and Responsibilitymentioning

confidence: 99%

Section: Determining Boundaries Of Rns' Professional Authority and Responsibilitymentioning

confidence: 99%

Recommendations From the Professional Advisory Committee on Nursing Practice in the Care of ECMO–Supported Patients

Melnikov

Furmanov

Gololobov

et al. 2021

Critical Care Nurse

View full text Add to dashboard Cite

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“…The relevance of human factors training has been highlighted by the crew resource management (CRM), developed by NASA and aviation industry ( 13 ). Mannequin-based neonatal ECMO training was first introduced in 2006 ( 14 ), though the relevance of mannequin-based training during the initiation and maintenance of an ECMO program ( 8 , 15 , 16 ) has not been included in the Extracorporeal Life Support Organization training guidelines. Single institutions self-tailor their educational curriculum, resulting in a wide heterogeneity of training practices and a suboptimal implementation of mannequin-based education among ECMO centers ( 17 ).…”

Section: Introductionmentioning

confidence: 99%

Start a Neonatal Extracorporeal Membrane Oxygenation Program: A Multistep Team Training

et al. 2018

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Background: Extracorporeal membrane oxygenation (ECMO) is a complex life-saving support for acute cardio-respiratory failure, unresponsive to medical treatment. Emergency events on ECMO are rare but require immediate and proficient management. Multidisciplinary ECMO team members need to acquire and maintain over time cognitive, technical and behavioral skills, to safely face life-threatening clinical scenarios.Methods: A multistep educational program was delivered in a 4-year period to 32 ECMO team members, based on guidelines from the Extracorporeal Life Support Organization. A first traditional module was provided through didactic lectures, hands-on water drills, and laboratory animal training. The second phase consisted of a multi-edition high-fidelity simulation-based training on a modified neonatal mannequin (SimNewB®). In each session, participants were called to face, in small groups, ten critical scenarios, followed by debriefing time. Trainees underwent a pre-test for baseline competency assessment. Once completed the full training program, a post-test was administered. Pre- and post-test scores were compared. Trainees rated the educational program through survey questionnaires.Results: 28 trainees (87.5%) completed the full educational program. ECMO staff skills improved from a median pre-test score of 7.5/18 (IQR = 6–11) to 14/18 (IQR = 14–16) at post-test (P < 0.001, Wilcoxon rank test). All trainees highly rated the educational program and its impact on their practice. They reported high-fidelity simulations to be beneficial to novice learners as it increased self-confidence in ECMO-emergencies (according to 100% of surveyed), theoretical knowledge (61.5%) and team-work/communicative skills (58%).Conclusions: The multistep ECMO team training increased staff' knowledge, technical skills, teamwork, and self-confidence, allowing the successful development of a neonatal respiratory ECMO program. Conventional training was perceived as relevant in the early phase of the program development, while the active learning emerged to be more beneficial to master ECMO knowledge, specific skills, and team performance.

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“…Non‐physician staff, such as nurses with special expertise in intensive care and ECLS therapy, 30 clinical perfusionists, physiotherapists, palliative care specialists, institutional coordinators for ECLS/ECMO, or if required clerics, are integral part of the multiprofessional team enabling ‘optimal’ ECLS treatment.…”

Section: Resultsmentioning

confidence: 99%

Use of extracorporeal circulation (ECLS/ECMO) for cardiac and circulatory failure –A clinical practice Guideline Level 3

et al. 2021

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Aims Worldwide applications of extracorporeal circulation for mechanical support in cardiac and circulatory failure, which are referred to as extracorporeal life support (ECLS) or veno‐arterial extracorporeal membrane oxygenation (va‐ECMO), have dramatically increased over the past decade. In spite of the expanding use and the immense medical as well as socio‐economic impact of this therapeutic approach, there has been a lack of interdisciplinary recommendations considering the best available evidence for ECLS treatment. Methods and Results In a multiprofessional, interdisciplinary scientific effort of all scientific societies involved in the treatment of patients with acute cardiac and circulatory failure, the first evidence‐ and expert consensus‐based guideline (level S3) on ECLS/ECMO therapy was developed in a structured approach under regulations of the AWMF (Association of the Scientific Medical Societies in Germany) and under use of GRADE (Grading of Recommendations Assessment, Development and Evaluation) criteria. This article presents all recommendations created by the expert panel, addressing a multitude of aspects for ECLS initiation, continuation, weaning and aftercare as well as structural and personnel requirements. Conclusions This first evidence‐ and expert consensus‐based guideline (level S3) on ECLS/ECMO therapy should be used to apply the best available care nationwide. Beyond clinical practice advice, remaining important research aspects for future scientific efforts are formulated.

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Training of Nurses and Continuing Education in ECMO

Cited by 4 publications

References 4 publications

Recommendations From the Professional Advisory Committee on Nursing Practice in the Care of ECMO–Supported Patients

Recommendations From the Professional Advisory Committee on Nursing Practice in the Care of ECMO–Supported Patients

Start a Neonatal Extracorporeal Membrane Oxygenation Program: A Multistep Team Training

Use of extracorporeal circulation (ECLS/ECMO) for cardiac and circulatory failure –A clinical practice Guideline Level 3

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