Simulation-Based Education of Endovascular Scrub Nurses Reduces Stress and Improves Team Performance

Rebecca Andrea Conradsen Skov*, Jonathan Lawaetz, Lars Konge, Lise Westerlin, Eske Kvanner Aasvang, Christian Sylvest Meyhoff, Katja Vogt, Tomas Ohrlander, Timothy Andrew Resch, Jonas Peter Eiberg

*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

6 Citationer (Scopus)
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Abstract

Introduction: Endovascular procedures have become commonplace in vascular surgery. This development calls for new training strategies for future specialists. Most simulation-based education (SBE) programs have a monodisciplinary focus on physicians, although successful surgery is a multidisciplinary team effort. Mental stress impairs the learning process and surgical performance and heart rate variability (HRV) can be measured as a proxy for both mental and physical stress. This study aims to assess how SBE of endovascular scrub nurses affects team performance and HRV during endovascular aneurysm repair (EVAR). Materials and methods: Prospective interventional study in which EVAR-inexperienced scrub nurses followed a focused SBE EVAR program. During real-life EVAR procedures, HRV was continuously recorded with a wireless electrocardiogram patch and multidisciplinary team performance was assessed with the Imperial College Error CAPture (ICECAP) tool, before and after the SBE program, allowing each scrub nurse to serve as their own control. Eight scrub nurses with experience in lower limb endovascular procedures, but not EVAR, were invited to participate. Results: Seven participants completed the study. In five of seven scrub nurses, HRV-derived stress levels during real-time EVAR procedures were lower after SBE compared to before SBE. Mean HRV increased from 24 msec to 35 msec (P < 0.001), indicating stress level reduction. Before SBE, the mean number of errors/hour was 7.3 (standard deviation ± 1.8) compared to 3.6 (standard deviation ± 2.7) after SBE. Most errors were categorized as technical (58 %) and communicative (23 %). Conclusions: SBE of scrub nurses may improve team performance and may lower mental stress during EVAR procedures. In this small study, we suggest using mental stress, as evaluated with HRV, and multidisciplinary team performance, as evaluated with ICECAP, to assess SBE effectiveness in real-case EVAR procedures. This SBE program and live ICECAP observations and electrocardiogram patches was well-accepted by scrub nurses and the entire team.

OriginalsprogEngelsk
TidsskriftJournal of Surgical Research
Vol/bind280
Sider (fra-til)209-217
Antal sider9
ISSN0022-4804
DOI
StatusUdgivet - 2022

Bibliografisk note

Funding Information:
One scrub nurse perceived the environment in the hybrid room as stressful and resigned from the study after completing one pre-SBE EVAR procedure. This statement was supported by objective end points. During this EVAR procedure, more errors were observed (mean of 9 errors/hour) and the stress level was higher (mean RMSSD: 14.9 msec [SD ± 9.7]).

Publisher Copyright:
© 2022 The Author(s)

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