Tamara Odom-Maryon

Comparison of two instructional modalities for nursing student CPR skill acquisition

AIMS The purpose of the study was to compare performance based measures of CPR skills (compressions, ventilations with bag-valve-mask (BVM), and single rescuer CPR) from two types of CPR courses: a computer-based course (HeartCode BLS) with voice advisory manikin (VAM) feedback and instructor-led (IL) training with traditional manikins. METHODS 604 nursing students from 10 schools of nursing throughout the United States were randomized by school to course type. After successful course completion, students performed 3min each of compressions; ventilations with BVM; and single rescuer CPR on a Laerdal Resusci Anne SkillReporter manikin. The primary outcome measures were: (1) compression rate, (2) percentage of compressions performed with adequate depth, (3) percentage of compressions performed with correct hand placement, (4) number of ventilations/min, and (5) percentage of ventilations with adequate volume. RESULTS There were no differences in compression rates between the two courses. However, students with HeartCode BLS with VAM training performed more compressions with adequate depth and correct hand placement and had more ventilations with adequate volume than students who had IL courses particularly when learning on hard molded manikins. During single rescuer CPR, students who had HeartCode BLS with VAM training had more compressions with adequate depth and ventilations with adequate volume than students with IL training. CONCLUSION Students who trained using HeartCode BLS and practiced with VAMs performed more compressions with adequate depth and ventilations with adequate volume than students who had IL courses. Results of this study provide evidence to support use of HeartCode BLS with VAM for training nursing students in CPR.

DELIBERATE PRACTICE of MOTOR SKILLS in Nursing Education: CPR AS EXEMPLAR

ABSTRACT Our study explored the effects of deliberate practice on the retention of cardiopulmonary resuscitation (CPR) psychomotor skills among nursing students. The practice sessions were short, six minutes a session one time a month. Differences in performance between students who had deliberate practice and a control group, with no practice beyond the initial training, were compared every three months for one year. The intervention group performed better than the control over the 12 months. There is a need in nursing education for deliberate practice of relevant and high‐use skills for students to improve their performance and gradually develop their expertise.

HeartCodeTM BLS with Voice Assisted Manikin for Teaching Nursing Students: Preliminary Results

ABSTRACT The purpose of this study was to evaluate the effectiveness of HeartCodeTM BLS, a self‐directed, computer‐based course for obtaining basic life support (BLS) certification. For part 2 of the course, students learned and practiced their cardiopulmonary resuscitation (CPR) psychomotor skills on a voice assisted manikin (VAM). Students from 10 schools of nursing were randomly assigned to two types of CPR training: HeartCode BLS with VAM or the standard, instructor‐led (IL) course with manikins that were not voice assisted; 264 students trained using HeartCode BLS and 339 had an IL course. When students passed their respective courses and were certified in BLS, their CPR skills were tested using the Laerdal PC SkillReportingtrade; System. Students who trained using HeartCode BLS and practiced their CPR skills on VAMs were significantly more accurate in their ventilations, compressions, and single‐rescuer CPR than students who had the standard, IL course with regular manikins.

Householder Status and Residence Type as Correlates of Radon Awareness and Testing Behaviors

OBJECTIVES The primary aim of this research was to assess radon awareness and testing across 2 housing types. DESIGN AND SAMPLE Cross-sectional prevalence study with time trends. National, probabilistic sample of 18,138 and 29,632 respondents from the 1994 and 1998 National Health Interview Surveys, respectively. RESULTS Odds ratio (OR) estimates confirmed that occupants of single family homes/townhomes were twice as likely to have ever heard of radon (1994: OR=2.18; confidence intervals [CI]=2.01-2.36) (1998: OR=2.26; CI=2.09-2.44) and also more likely to know if their household air had been tested for radon (1994: OR=2.04; CI=1.57-2.65) (1998: OR=1.38; CI=1.19-1.59) as occupants of apartments/condominiums. Time trend analyses revealed that radon awareness improved from 69.4% to 70.7% and home testing among those with knowledge of radon increased from 9.7% to 15.5% over the 4-year period. CONCLUSIONS Housing type provided fairly stable estimates of radon awareness and testing. Findings demonstrate that housing status may be a useful variable to differentiate risk for radon awareness and testing. Public health nurses should consider their clients housing type when assessing families for environmental risks.

Student satisfaction and self report of CPR competency: HeartCode BLS courses, instructor-led CPR courses, and monthly voice advisory manikin practice for CPR skill maintenance.

This study evaluated the effects of brief monthly refresher training on CPR skill retention, confidence, and satisfaction with CPR skill level of 606 nursing students from ten different US schools. Students were randomized to course type, HeartCode™ Basic Life Support (BLS) or an instructor-led (IL) course, and then randomized to a practice group, six minutes of monthly practice or no further practice. End-of-study survey results were compiled and reported as percentages. Short answer data were grouped by category for reporting. Fewer HeartCode™ BLS students were satisfied with their CPR training compared to the IL students. Students who practiced CPR monthly were more confident than students who did not practice. Monthly practice improved CPR confidence, but initial course type did not. Students were most satisfied when they participated in the IL courses and frequent practice of CPR skills.

The Value of Community-Focused Interprofessional Care in Peru for Developing Cultural Competency in Health Professions Students

Abstract International immersion experiences for health-care students have increased over the past 10 years. Students and faculty expect these experiences to increase cultural competency; however, research on outcomes of these programs has lacked rigor. Over a 4-year period, groups of nursing and other health professions students spent 3 weeks in Peru providing primary care and health education. Students attended pre-departure seminars addressing personal travel health and safety, culture and health care in Peru, working with interpreters, and ethics of international health care. Student participants (N = 77) completed an instrument assessing self-perceived cultural competency before and after the experience. Results of pre- and post-immersion scores showed significant increases in perceived cultural competency and increased self-efficacy in cultural knowledge, skills, and attitudes for four groups of students. Implications and future directions are discussed and recommended.

Pediatric Patients with Asthma: A High-Risk Population for Subsequent Hospitalization

Objectives. Asthma is one of the most common chronic conditions among children and is one of the leading causes for pediatric hospitalizations. More evidence is needed to clarify the risks of repeat hospitalization and the underlying factors contributing to adverse health outcomes among pediatric patients hospitalized with asthma. The purpose of this study was to examine the risk of subsequent hospitalizations among pediatric patients hospitalized with asthma compared to a reference cohort of children hospitalized for all other diagnoses. Methods. The Washington State (WA) Comprehensive Hospital Abstract Reporting System (CHARS) was used to obtain data for the study. Data describing 81,946 hospitalized pediatric patients admitted from 2004 to 2008 were available. The risk of subsequent hospitalization among children admitted for asthma as compared to a reference cohort was examined. Results. The asthma cohort had a 33% (HR = 1.33 [99% confidence interval (CI) 1.21–1.46]; p < .001) increased risk of subsequent hospitalization from 2004 to 2008. Children in the asthma cohort under the age of 13 years demonstrated a significant increased risk of subsequent hospitalization as compared to the age-matched reference cohort of children without asthma. Those in the asthma cohort who were 3–5 years old demonstrated the highest risk (50%) of subsequent hospitalization (HR = 1.50 [99% CI 1.23–1.83]; p < .001). Conclusions. Study results can be utilized in the development of appropriate interventions aimed at preventing and reducing hospital admissions, improving patient care, decreasing overall costs, and lessening complications among pediatric patients with asthma.

Competence in CPR.

Nurses need more frequent training to meet new guidelines that emphasize the rate and depth of chest compressions.

Childhood Attention-Deficit/Hyperactivity Disorder Prescribing by Prescriber Type and Specialty in Oregon Medicaid

OBJECTIVE This study compares nurse practitioner (NP) and physician (MD/DO) prescribing patterns for treatment of children with an attention-deficit/hyperactivity disorder (ADHD)-related diagnosis covered by Oregon Medicaid from 2012 to 2013. METHODS This study is a limited data set review of Oregon pharmacy claims for youth aged 3-18 at time of prescription fill, who were continuously enrolled for at least 10 months of the index year. Claims with selected ICD-9 codes (n = 197,364) were further defined by 30-day prescriptions and prescription drug events (PDE) linked to each prescriber type of interest. Descriptive statistical analysis of variables included prescriber type (NP vs. physician) and specialty (generalist vs. specialist), child age, and controlled versus noncontrolled drug type. RESULTS A total of 82,754 complete 30-day prescriptions for 10,753 children from 1785 unique prescribers (78 NP specialists; 303 NP generalists; 162 physician specialists; and 1242 physician generalist prescribers) and 16,669 PDE were analyzed. Physicians prescribed more than 81% of all ADHD medications, and physician generalists prescribed nearly 60% of all prescriptions. Sixty-four percent of 30-day supply prescriptions (n = 52,678) were controlled substances. Generalists, both NPs and physician prescribers, prescribed controlled medications more often than specialists. Physician specialists consistently prescribed controlled substances for all age groups, while NP specialists prescribed more controlled substances as child age increased. Rates of controlled medications prescribed generally increased, as children got older, regardless of provider type. CONCLUSION NPs overall prescribe in a similar pattern to physicians when given the authority to prescribe controlled substances for ADHD. Comparisons between prescriber types for controlled substance prescribing by age should be explored further to identify possible variance from national guidelines.

Findings from a nursing student CPR study: implications for staff development educators.

This article reports a secondary data analysis of a year-long study with 606 nursing students involving brief monthly CPR practice with voice-activated manikins versus no practice. Findings indicate that even with monthly practice and accurate voice-activated manikin feedback, some students could not perform CPR correctly. Implications of these findings for staff educators are discussed.